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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 Dyane Harwood on November 18, 2013, at 15:31:57
I am taking 30 mg Parnate and 600 mg lithium. I am curious how much lithium others take with this MAOI. Taking Parnate with lithium has been incredibly helpful in lifting my longtime depression. (I have bipolar one) I am facing pressure from others (loved ones, counselors and pdoc) to lift the lithium dose to 900 mg because they are concerned that mania will set in eventually at "just" 600 mg. I have absolutely no signs of hypomania or mania and the fatigue I do have from the Parnate acts as a deterrent to these conditions, in my opinion. I am afraid that if I do raise the lithium to 900 mg, there is a chance of screwing everything up. I would be so grateful to any of you who have experience with this specific combo - thanks so much.
Posted by stargazer2 on November 18, 2013, at 16:05:03
In reply to How much lithium do you take w/Parnate?, posted by Dyane Harwood on November 18, 2013, at 15:31:57
I take 900 mg Lithium with Nardil and previous to that took 900 with Marplan, so both MAO's. I have been concerned that 900 is too much myself as I have unipolar depression and I'm afraid it will make me too "flat" and uninterested in life
and I don't show signs of bipolar but my pdoc feels it keeps my moods from becoming too unstable so we keep it at 900. I'm not sure that is the right thing to do. It really all is a chemical experiment anyway, isn't it? I've been on meds for more than 20 years so I know how inexact this process is. The docs don't really know what theyre doing. I've lost so much life to this disease it isn't funny, it's very frustrating and painful to never know if I will beat this illness. After this long I don't think I will.
Posted by Dyane Harwood on November 19, 2013, at 10:29:55
In reply to Re: How much lithium do you take w/Parnate?, posted by stargazer2 on November 18, 2013, at 16:05:03
Hi stargazer2 and thank you so much for replying to my post. Doctors do *not* know everything, especially about an illness as baffling as bipolar. All I know is that my taking 600 mg lithium/day seems to be working well in tandem with the Parnate. I have absolutely no signs of hypomania or mania. I did have heightened energy the first week, but then fatigue (one of Parnate's notorious side effects) set in big-time, and in a way I feel it has kept any hypomania from settling in. I had a blood level done a couple weeks ago and my Li was .5 - low, I know, but technically within the therapeutic range according to Wikipedia and my pdoc. I hope with all my heart that you and I will beat this illness...you never know, but bipolar scares the %&^*&&* out of me - always has, always will.
Posted by stargazer2 on November 19, 2013, at 13:39:46
In reply to Re: How much lithium do you take w/Parnate?, posted by Dyane Harwood on November 19, 2013, at 10:29:55
I wish you much luck with your illness as well. It really is a crap shoot directed by your pdoc and hopefully they are skilled enough to make the right decisions for your life. I feel like my life has a mind of its own and it is not a direct and purposeful one lately but I haven't given up yet although a few weeks ago I was moving in that direction.
SG2
Posted by Dyane Harwood on November 19, 2013, at 14:53:47
In reply to Re: How much lithium do you take w/Parnate?, posted by stargazer2 on November 19, 2013, at 13:39:46
Hey stargazer2 - I'm so sorry to hear that past few weeks have been rough for you. I know how that is. I really do. A measly month ago I wanted out. I have two beautiful little ones, though, so while I had a plan, I didn't want to go forward with it. I have never attempted but come close to numerous times that resulted in hospitalization and both unilateral and bilateral ECT. I just cannot risk messing with my med. combo. now that I can function again. As long as I remain close to .5 with my lithium levels, I think I can "get away" with 600 mg of lithium. I know it's a gamble, but when I even think of raising my lithium I feel absolutely terrified. It sucks. The more time I get under my belt, the more confident I will feel with my choice. I am also going to study this particular combo. - there are a couple studies out there from the 1970's that are very convincing in terms of combining lithium and Parnate, but these two studies do not name the actual dosages taken, which frustrates me. I can buy one study for $35 that I will then be able to view for a whopping 24 hours, but there is no guarantee it will name dosages...my therapist thinks I should spend the $. I'll let you know if I do it!
Posted by phidippus on November 21, 2013, at 17:37:52
In reply to How much lithium do you take w/Parnate?, posted by Dyane Harwood on November 18, 2013, at 15:31:57
Typically you want to have a lood serum level of at least 1.0 in order for the lithium to be effective.
Eric
Posted by Christ_empowered on November 22, 2013, at 13:33:43
In reply to Re: How much lithium do you take w/Parnate? » Dyane Harwood, posted by phidippus on November 21, 2013, at 17:37:52
Could you add something? Like a very low dose atypical or something?
Posted by Dyane Harwood on November 22, 2013, at 15:54:40
In reply to Re: How much lithium do you take w/Parnate?, posted by Christ_empowered on November 22, 2013, at 13:33:43
Hi there Christ empowered - thanks for your post. As a "newbie" to this forum, it means a lot to me to get your responses. I've taken atypical antipsychotics in the past and I did not have any response to them.
I guess I'd rather up the lithium than add one more drug to my system...even at a low dose. I'm holding fast to my current combo. and meet with my pdoc tomorrow to see what he has to say.
I wish you well and God bless you for taking the time to make a suggestion! :)
Posted by Christ_empowered on November 22, 2013, at 23:17:33
In reply to Re: How much lithium do you take w/Parnate?, posted by Dyane Harwood on November 22, 2013, at 15:54:40
Cool. Probably a good strategy (its your body, anyway...)How do you feel on lithium? I supposedly have Bipolar, but its more on the psychotic spectrum of bipolar, so lithium isn't first line for people like me. I've always been curious about how people felt on the stuff.
I know you don't want to add another drug, but it just dawned on me that, back in the day, docs sometimes used Klonopin (yes, the current "it" benzo) in combo with more traditional drugs for bipolar and some psychotic disorders. I know its another drug, and there's a dependence issue, but...it tends to be fairly tolerable, its cheap, and its relatively humane, as mood stabilizing drugs go. Wouldn't kill off full-fledged mania, but it could take the edge off, so maybe (????) you could do with a lower dose of lithium.
Just another thought...
...unlike the atypicals (or older drugs), there wouldn't be a TD or EPS risk.
Posted by Dyane Harwood on November 24, 2013, at 9:49:34
In reply to Re: How much lithium do you take w/Parnate?, posted by Christ_empowered on November 22, 2013, at 23:17:33
Hi again and thanks for your thoughtful message! I have made my peace being on lithium - I did feel that at 900 mg I was more lethargic. I could be wrong about that, but that's my gut feeling. I've been as high up as 1575 mg, so it's nice to not be way up there!!! :000
I have had a major benzo addiction in the past. My current pdoc is an addiction specialist and does not want to prescribe me any benzos for anxiety, so I take Baclofen. I've taken Klonopin, Ativan, Xanax, Lithium and others I'm spacing out on, I'm sure. They all make me tired and out-of-it and since I take care of my two little girls and drive frequently every day, it's not an option for me right now. (But thanks for the idea all the same!!)
I wish you well and really appreciate your taking the time to write. God bless you, Dyane :)
>
> Cool. Probably a good strategy (its your body, anyway...)
>
> How do you feel on lithium? I supposedly have Bipolar, but its more on the psychotic spectrum of bipolar, so lithium isn't first line for people like me. I've always been curious about how people felt on the stuff.
>
> I know you don't want to add another drug, but it just dawned on me that, back in the day, docs sometimes used Klonopin (yes, the current "it" benzo) in combo with more traditional drugs for bipolar and some psychotic disorders. I know its another drug, and there's a dependence issue, but...it tends to be fairly tolerable, its cheap, and its relatively humane, as mood stabilizing drugs go. Wouldn't kill off full-fledged mania, but it could take the edge off, so maybe (????) you could do with a lower dose of lithium.
>
> Just another thought...
>
> ...unlike the atypicals (or older drugs), there wouldn't be a TD or EPS risk.
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