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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 metamorphosis on December 29, 2012, at 13:24:32
I just started Parnate and am having insomnia. I hope this will mellow or pass with time. I have used Ambien but it just isn't strong enough. I believe I am cross tolerant with the benzo, Klonopin. Which I take daily.
My question is, everyone seems to be mentioning nortriptyline as an adjunct to Parnate. What about amitriptyline, either as a sleep aid or to potentiate and complement Parnate???
My p-doc is open to adding a TCA in time. I have used 10mg of amitriptyline in the past for insomnia. What doses are used for sleep and/or therapeutic value?
Also, what are there major benefits of using nortriptyline over amitriptyline?I don't have insurance and I believe amitriptyline is much more affordable.
Posted by SLS on December 29, 2012, at 14:02:29
In reply to Parnate+amitriptyline in lieu of nortriptyline, posted by metamorphosis on December 29, 2012, at 13:24:32
Hi M.
I responded to your question in a prevous thread.
http://www.dr-bob.org/babble/20121217/msgs/1034137.html
Since you are already on amitriptyline, I would continue with it and begin titrating the dosage to 150 mg/day or more if you can tolerate it.
- Scott
Posted by metamorphosis on December 29, 2012, at 18:06:18
In reply to Re: Parnate+amitriptyline in lieu of nortriptyline, posted by SLS on December 29, 2012, at 14:02:29
> Hi M.
>
> I responded to your question in a prevous thread.
>
> http://www.dr-bob.org/babble/20121217/msgs/1034137.html
>
> Since you are already on amitriptyline, I would continue with it and begin titrating the dosage to 150 mg/day or more if you can tolerate it.
>
>
> - ScottThanks Scott, I am pretty new to reading and posting on this site, but there are a lot of people with MAOI experience on here. And you have been very helpful to all. Just from reading your posts, you are very knowledgeable. are you currently in university or work in the mental health field? I am intrigued as to how you have gained so much knowledge? :)
This is of topic from my thread, but I would like to ask you a few things. I have read past posts dating back to the early 2000s. I still have a few key questions.
My pdoc is very open to adding medications cautiously to the Parnate. I have only been on the Parnate for a week but my depression seems to have worsened. I can almost directly pinpoint this to my stoping modafinil before I started the
Parnate. The same situation has happened in the past with my stopping modafinil. It works amzingly well for my depression. So, before I babble on for to long let me list what I am on.
-Parnate: 30mg,1 week (am already dealing with insomnia issues)
-Lamictal: 300mg,2 yrs.( has been a great mood stabilizer and AD for me)
-Klonopin: 4mg,2 yrs. ( yes, I will definitely have to do a very slow reduction off of it. Possibly using the Ashton method. I am hoping this new combo. of meds along with perhaps another anxiolytic will help!)
-Ambien: 10mg,1 week (using it for insomnia but not working. I suspect cross-tolerant with my benzo)I see my pdoc in a week. He is open to listening to my ideas. I have been seeing him for over 2 yrs. He is willing to add the modafinil back after he sees how I react to the Parnate.
Is it usually okay to carefully add modafinil to Parnate? I was on 200mg and was great for my mood. Just concerned it may add to insomnia?
What are some of your recommendations for sleep. It seems like nortriptyline would be the first choice? Is that because of its lower anti-cholinergic and anti-histamine effects?
I have always had insomnia and have used trazadone in the past. I have read of some people on here using it for sleep with an MAOI. Isn't that dangerous due to it's 5HT properties?
I have used it anywhere from 25-100mg (rarely) for sleep. Also, I have used a low dose of doxepin, around 10mg and amitriptyline 10 mgs for sleep.Last questions-
What are your first choices in order to help boost Parnate's AD effect?
What are your first choices for insomnia?
What anxiolytic other then a benzo would you recommend?
Would the TCA's help with this?
Finally the integration of modafinil with Parnate good???
Any other ideas of meds may help???
I am diagnosed with SA, GAD, atypical and refractory depression, and OCD.Sorry for the long post!
If you can find the time you can contact me on MSN at rappaport303@hotmail.com or if you have an instant message board you prefer.Thaks again!!!!!!
This is the end of the thread.
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