![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by moisha on February 28, 2013, at 21:22:45
dear babble members
I would really appreciate any information on how you think parnate improved either your depression and/or social anxiety.
information on how the treatment progresses- what one may expect to occur whilst taking parnate is extremely welcome. you do not have to be very scientific. anecdotal accounts are welcome indeed.
anything of a positive nature related to your experience of parnate in your recovery would benefit me.
kind regards
m
Posted by SLS on February 28, 2013, at 21:49:36
In reply to parnate induced improvement, posted by moisha on February 28, 2013, at 21:22:45
> dear babble members
>
> I would really appreciate any information on how you think parnate improved either your depression and/or social anxiety.
>
> information on how the treatment progresses- what one may expect to occur whilst taking parnate is extremely welcome. you do not have to be very scientific. anecdotal accounts are welcome indeed.
>
> anything of a positive nature related to your experience of parnate in your recovery would benefit me.
>
> kind regardsI am currently taking 80 mg/day of Parnate. In my estimation, the range of effective dosages for parnate is 40 - 80 mg/day. Doctors are often sheepish in prescibing this drug because of lack of experience with it. Patients are often underdosed and never reach a dosage high enough to produce a robust therapeutic response.
Start low and go slow. You might want to spend the first week titrating from 10 mg/day to 30 mg/day. You can then increase to 40 mg/day for the next week or two, depending on how well you tolerate the side effects. Orthostatic hypotension and dizziness can be problematic at first, but often disappears with continued treatment. You might then want to give each dosage increase 2 - 3 weeks to evaluate your treatment response. A few doctors will use a high-dose strategy for treatment resistant cases. This involves dosages of 120 mg/day and higher. Generally speaking, 80 mg/day is not a dosage that will approach toxicity.
Of course, these treatment strategies should be negotiated with your doctor.
Parnate by itself (monotherapy) is not sufficient for the the therapeutic response I am now experiencing. Adding nortriptyline and lithium has helped in conjunction with Lamictal and Abilify. I also take prazosin and minocycline.
- Scott
Posted by ikasug on March 1, 2013, at 12:24:49
In reply to Re: parnate induced improvement » moisha, posted by SLS on February 28, 2013, at 21:49:36
I had great benefits from Parnate at 60mg. I was able to buy a car, move out of my parents' house within 4 months of becoming employed (and about 5 and a half of living there, having dropped out of graduate school), and open up to others. I had gained over 100 pounds while in Ohio and lost 75 to hit my usual weight.
Unfortunately I was still depressed when alone and prone to episodes that affected my work quality. I was also still anxious, a problem considering that I was diagnosed with GAD. My benzos were PRN, but I would run out because I had to add doses before stressful meetings at work and many social situations.
Also, Parnate gave me substantial orthostatic hypotension. It waned with time, but I was always aware of it existing. I suffered from very minor urinary retention on occasion.
Other than this, I had perfect bloodwork and blood pressure. My general health improved immensely.
A trial of 200mg Lamictal and 450mg Wellbutrin last fall ended in disaster. I immediately sank back into such a severe depression that my job was in jeopardy. I was able to recognize it and had an emergency appointment with the pdoc.
I now take Nardil 60mg with better results for depression and anxiety and have hopped around benzos from Ativan (while on Parnate) to Xanax to Ativan before resting on Klonopin. I have pdoc on Monday but it is unlikely that I will raise the dose because of water weight gain (thankfully this gain was right before a workplace contest to lose weight with ridiculously large cash prizes -- 3x my bonus for first place!!) and urinary retention. It takes me quite a while to pee, sometimes 2-3 minutes of sitting on the toilet, and especially in a public restroom. Even at bars and nightclubs (I love to dance), while drunk, it still takes me 2-3 minutes of sitting, which is embarrassing for a male. It's not that I'm particularly worried about what others think of me but standing at a urinal while colleagues come in and out can makes the time it takes to get going feel a lot longer than it is.
Posted by ikasug on March 1, 2013, at 12:27:09
In reply to parnate induced improvement, posted by moisha on February 28, 2013, at 21:22:45
also, it seems like MAOIs were in vogue on babble last year, but now everyone seems to have moved on. is this because of ketamine trials or are we all sick of Nardil and Parnate now?
Posted by Phillipa on March 1, 2013, at 12:52:45
In reply to Re: parnate induced improvement, posted by ikasug on March 1, 2013, at 12:27:09
True from what I read on hear seems ketamine is being used by quite a few and others have gone back to SSRI's and drugs they were on before. Seems to have worked for most of them. Phillipa
Posted by Roslynn on March 1, 2013, at 14:11:54
In reply to parnate induced improvement, posted by moisha on February 28, 2013, at 21:22:45
Hi, I have started a trial of Parnate but I am only on 20mg/day, going up very slowly. I will let you know if I start to feel better.
Roslynn
Posted by baseball55 on March 1, 2013, at 18:23:31
In reply to parnate induced improvement, posted by moisha on February 28, 2013, at 21:22:45
Parnate pulled me out of a deep, vegetative depression within a couple of days of taking it. It didn't really stablize my moods (lamictal helped with this), but I never again had that kind of depression where you can't move and lie in bed for weeks. I've been taking it for three years and now consider myself to be in remission.
Posted by bleauberry on March 3, 2013, at 12:17:49
In reply to parnate induced improvement, posted by moisha on February 28, 2013, at 21:22:45
I only tried parnate for about 2 weeks, and only at low doses, so maybe I am not a good example. I couldn't stay with it because I was getting ready for antibiotic treatments, and there is just too much mystery and unknowns to be combining stuff with parnate safely.
My highest dose was 2.5mg. Yeah, you read that correct. Within a few hours I actually felt more down. That lifted after a few hours, and I felt better than I had started. By day 3, I was definitely in a better place than prior to parnate.
Since it incapacitates the MAO enzyme for at least a week, I only took it once every 2 or 3 days.
For me the benefits were:
Remarkable anti-anxiety.
Remarkable pro-social.
Slightly remarkable depression improvement.it did worsen my sleep and it did lower my blood pressure even at those tiny doses.
Posted by ikasug on March 5, 2013, at 12:16:44
In reply to Re: parnate induced improvement » ikasug, posted by Phillipa on March 1, 2013, at 12:52:45
I just can't imagine going back to an SSRI after an MAOI. Maybe it's because I've had success.
As for Ketamine trials I know they provide immediate relief, but I have serious doubts as to whether the benefits can be sustained without psychotherapy particularly psychoanalysis. My experiences with NMDA receptor drugs did not induce any lasting change, and in fact precipitated a major depressive episode after a few days of euphoric relief. I've had the same results in longevity just by getting to a functional level through MAOIs and initiating psychoanalysis.
Posted by ikasug on March 5, 2013, at 12:19:18
In reply to Re: parnate induced improvement, posted by ikasug on March 5, 2013, at 12:16:44
My distaste for CBT and DBT are not because they are ineffective in fact my dynamic therapist used abbreviated CBT because it does help. But the benefits are not permanent. You have to understand what unconscious ideas are keeping you ruminating. And because I think this board is intelligent, and also because we put so much effort into treating our conditions, that success is almost a 'loss.' I wouldn't use Ketamine without concomitant psychoanalysis to uncover the unconscious thought patterns that keep us resistant to change.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.