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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by crabcakebenny on April 24, 2016, at 15:16:46
Parnate is a weird med. I started it believing it would be a magic bullet for TRD/anhedonia/persistent dysthymia. During my initial dose escalations to 30 and 40 mg, I felt almost hypomanic. It was great. I've been taking 50 mg for a little over a week, and now it feels different in a worse way: immediately after I take it I have these bizarre, physical side-effects (heart palpitations, GI reflux, prickly sensations on scalp). I also notice reduced/inconsistent efficacy, and sometimes even this horrible, numb agitation that feels like I overdosed on the wrong pill.
It doesn't make sense to me that a 10 mg dose increase would ruin the quality of the med, so I'm chalking it up to initial side-effects/possible worsening of depression before this dose smooths over. I did elevate the dose pretty fast after I was on 30 mg for awhile. Did anyone notice effects like this on Parnate, and is it temporary?
Posted by rjlockhart37 on April 24, 2016, at 22:29:58
In reply to Parnate - feel crappy at random times in the day, posted by crabcakebenny on April 24, 2016, at 15:16:46
parnate has some stimulant effects, not 'actual' stimulant properties but it's effects can be stimulating and cause you have insomnia, i've read here on the boards over the years similar symptoms your describing, it's a great med, it work well for major depression, but on some people it can be have caffeine, wellbutrin feeling. It's MAOI - B inhitor so it targets mainly dopamine and norepinephrine, there other it does, but like Nardil and Marplan, are MAOI - A, they target maily serotonin there better for anxiety, parnate is better for low energy
there's lots posters here that take, so they should post their experiences
Posted by crabcakebenny on April 25, 2016, at 19:40:59
In reply to Re: Parnate - feel crappy at random times in the day, posted by rjlockhart37 on April 24, 2016, at 22:29:58
I definitely feel it's better for low energy early in the day, but I also suffer the infamous, midday crash on parnate. I think I either need to go to 60 mg/day to inhibit more MAO-A or augment with something like Nortryptiline. Are you using an MAOI?
Posted by rjlockhart37 on April 26, 2016, at 1:12:03
In reply to Re: Parnate - feel crappy at random times in the day, posted by crabcakebenny on April 25, 2016, at 19:40:59
no i take Prozac 80mg the max
but i've read about parnate tons of times here on babble over the years, the infamous crash it has.....it seems like its the same with dextroamphetamine, it improves mood but it's crash is not pleasant, you feel washed out like all the energy reserves have been depleted
Posted by SLS on April 26, 2016, at 6:29:14
In reply to Re: Parnate - feel crappy at random times in the day, posted by rjlockhart37 on April 26, 2016, at 1:12:03
I divide up my doses of Parnate to three times a day.
80 mg/day:
30 mg morning
30 mg afternoon
20 mg nightSome people for whom night dosing produces insomnia can take Parnate as:
40 mg morning
40 mg afternoonor
30 mg morning
30 mg noon
20 mg 3:00 PMI never really had a midday slump with Parnate.
- Scott
Posted by crabcakebenny on April 26, 2016, at 23:50:39
In reply to Re: Parnate - feel crappy at random times in the day, posted by SLS on April 26, 2016, at 6:29:14
Your lucky you have a shrink that will prescribe you high doses. I know supratheraputic doses of Parnate are well-tolerated and frequently more effective, but my pdoc stated she'll only go up to the FDA max - 60 mg.
If I'm honest, the Parnate's fine for depression but it's either exacerbating my OCD or it preceded a relapse; the anxiety's getting so bad any mood gains I'm receiving are sort of negligible.
Posted by SLS on April 27, 2016, at 7:06:30
In reply to Re: Parnate - feel crappy at random times in the day, posted by crabcakebenny on April 26, 2016, at 23:50:39
> Your lucky you have a shrink that will prescribe you high doses. I know supratheraputic doses of Parnate are well-tolerated and frequently more effective, but my pdoc stated she'll only go up to the FDA max - 60 mg.
>
> If I'm honest, the Parnate's fine for depression but it's either exacerbating my OCD or it preceded a relapse; the anxiety's getting so bad any mood gains I'm receiving are sort of negligible.80 mg/day is not supratherapeutic. The recommendations found in the PDR / package label are subtherapeutic - although not by much. Through the many years of working with Parnate, I feel confident in saying that the actual therapeutic range is 40 - 80 mg/day. 120 mg/day is used occasionally and considered supratherapeutic. That being said, 60 mg/day is certainly not generally too low. You seem to be responding to it, albeit with unacceptable adverse effect. I would consider trying Nardil or Marplan if you cannot resolve the OCD and anxiety. I'm sorry that things have become so complicated for you.
- Scott
Posted by crabcakebenny on April 28, 2016, at 15:10:26
In reply to Re: Parnate - feel crappy at random times in the day » crabcakebenny, posted by SLS on April 27, 2016, at 7:06:30
> > Your lucky you have a shrink that will prescribe you high doses. I know supratheraputic doses of Parnate are well-tolerated and frequently more effective, but my pdoc stated she'll only go up to the FDA max - 60 mg.
> >
> > If I'm honest, the Parnate's fine for depression but it's either exacerbating my OCD or it preceded a relapse; the anxiety's getting so bad any mood gains I'm receiving are sort of negligible.
>
> 80 mg/day is not supratherapeutic. The recommendations found in the PDR / package label are subtherapeutic - although not by much. Through the many years of working with Parnate, I feel confident in saying that the actual therapeutic range is 40 - 80 mg/day. 120 mg/day is used occasionally and considered supratherapeutic. That being said, 60 mg/day is certainly not generally too low. You seem to be responding to it, albeit with unacceptable adverse effect. I would consider trying Nardil or Marplan if you cannot resolve the OCD and anxiety. I'm sorry that things have become so complicated for you.
>
>
> - ScottI appreciate your response. I'm actually taking 50 mg, I want to move up to 60. Regardless, I'm feeling a lot better today after resisting compulsions and exercising this week. I've been trying to add armodafinil to my regimen and that could be what was exacerbating the OCD.
I don't know if this is accurate, but it's almost like Parnate augments whatever mood I'm in (whether it be good or bad). I'm not trying to go off this med, I'm afraid of titrating down. I'll just try to have faith and continue what I'm doing.
This is the end of the thread.
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