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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Frequent Fryer on July 27, 2012, at 3:21:20
Hi Guys.
5th time taking parnate. i always get a great response from it for 2 weeks then I cant notice any benefits from it at all, even after taking the dose up to 100mg. I have tried phentermine with it and it didnt put my BP pulse above the norm and felt great.
My psych said I could try concerta with
it in hospitall.
But has anyome else had parnate poop out and then regain a realy strong long term effect by adding Nortriptaline alone?Regards
Posted by SLS on July 27, 2012, at 8:49:36
In reply to Parnate help please SLS or anyone else, posted by Frequent Fryer on July 27, 2012, at 3:21:20
> Hi Guys.
> 5th time taking parnate. i always get a great response from it for 2 weeks then I cant notice any benefits from it at all, even after taking the dose up to 100mg. I have tried phentermine with it and it didnt put my BP pulse above the norm and felt great.
> My psych said I could try concerta with
> it in hospitall.
> But has anyome else had parnate poop out and then regain a realy strong long term effect by adding Nortriptaline alone?
>
> RegardsI am certainly not as responsive to treatment now as I was 25 years ago. However, my first encounter with Parante + desipramine was a very successful one. I remained free of depression for 9 months, whereupon my doctor opted to discontinue treatment. I relapsed two months later. Unfortunately, when I returned to the same treatment, it no longer worked. The story gets more complicated than that, but that's the gist of it. It should be noted, however, that my prior responses to either of these drugs alone was that of a brief, 3-day improvement followed by relapse. I would say that there was a genuine synergy between MAOI and TCA.
I would think that adding nortiptyline at this juncture makes more sense for you than playing around with stimulants and amino acids. Supposedly, it is safer to start both drugs together or add the to ongoing TCA treatment. However, I have added the TCA to ongoing Parnate treatment without sequalae. Low blood pressure (orthostatic hypotension) was a problem at first, but that dissipated within a few months. If you are concerned about hypertension, you could monitor your blood pressure early in treatment and be on guard for the development of headaches. It is likely that your heart rate will increase. This is to be expected, and is generally not dangerous. I would be concerned if your HR goes above 120 bpm, though. Personally, I feel that 90 - 120 bpm is acceptable with a tricyclic early in treatment. I don't imaging too many people will agree with me. For me, HR has decreased over time with Parnate + nortriptyline. Right now, it is 92 bpm. Interestingly, although the HR is elevated, the blocking by nortriptyline of peripheral NE alpha-1 receptors should reduce the aferload on the heart.
- Scott
Posted by Phillipa on July 27, 2012, at 10:03:39
In reply to Re: Parnate help please SLS or anyone else » Frequent Fryer, posted by SLS on July 27, 2012, at 8:49:36
Scott that doc did to you what one did to me with a different med. Doing so well on it and he wanted me in a celexa trial when new. Why did this doc discontinue your parnate? Sorry Frequent Flyer for hyjacking your thread. I just wonder why docs sometimes discontinue a treatment if it's working. Phillipa
This is the end of the thread.
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