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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 Rob829 on August 9, 2002, at 20:05:05
I have been diagnosed with dysthymia and possibly a sort of "double depression" because sometimes I get so depressed I can barely function. I started taking 10 mg Parnate about 5 weeks ago. I gradually increased the dose up to 40 mg, which I started taking a week ago. The problem is, sometimes my depression will go completely away, and I have more energy and enjoy doing things, but then I will crash back down again. My doctor thinks this will improve in a few months, I'm not so sure. Also, I usually feel worse in the morning, and better at night. Anyone else have this happen or any suggestions?
Posted by Angel1 on August 9, 2002, at 21:56:40
In reply to Parnate works sometimes..., posted by Rob829 on August 9, 2002, at 20:05:05
HI Rob,
When I was severely depressed I could tell what time it was without looking at the clock. At 11a.m. every morning my anxiety would peek. Then eventually throughout the day my depression and anxiety would slowly get better, but in no way resolve. But sometimes, by the end of the evening I would feel completely normal.....only to have the process start all over the next day.
I asked by psychiatrist about this and he said it
has something to do with your body's natural circadian rythyms. He said it is a very common symptom of depression.
Luckily, my depression is under control. I take
100mg of desipramine, a tricyclic antidepressant.
It will go away once you find a drug that works for you. I used to hate waking up, because I knew what was ahead. Now, morning is my favorite time of day. I wish you the best in your continued search for freedom from the "demon"
Posted by cybercafe on August 10, 2002, at 5:27:42
In reply to Parnate works sometimes..., posted by Rob829 on August 9, 2002, at 20:05:05
Maybe my post in "Parnate poop-out" answers your question
Posted by SLS on August 10, 2002, at 8:40:45
In reply to Parnate works sometimes..., posted by Rob829 on August 9, 2002, at 20:05:05
> > I have been diagnosed with dysthymia and possibly a sort of "double depression" because sometimes I get so depressed I can barely function. I started taking 10 mg Parnate about 5 weeks ago. I gradually increased the dose up to 40 mg, which I started taking a week ago. The problem is, sometimes my depression will go completely away, and I have more energy and enjoy doing things, but then I will crash back down again. My doctor thinks this will improve in a few months, I'm not so sure.
He might be right. Even at the same dosage, there is often a saw-tooth pattern towards improvement. Up 2, down 1, up 2, etc. It might take a month at the right dosage before you see a discernable improvement, and 6 or more months to feel fantastic. 40mg is the minimum dosage of Parnate that would be considered therapeutic. When it worked for me, I needed 60mg. I have taken as much as 150mg.
That you feel such significant, although intermittent improvement would seem to me to be a hopeful sign.
> > Also, I usually feel worse in the morning, and better at night. Anyone else have this happen or any suggestions?
> When I was severely depressed I could tell what time it was without looking at the clock. At 11a.m. every morning my anxiety would peek. Then eventually throughout the day my depression and anxiety would slowly get better, but in no way resolve. But sometimes, by the end of the evening I would feel completely normal.....only to have the process start all over the next day.
The pattern of feeling worse in the morning and better in the evening is a feature of the original description of "endogenous" or "melancholic" major depression. This type of depression is noted to be especially responsive to tricyclic antidepressants.
> Luckily, my depression is under control. I take 100mg of desipramine, a tricyclic antidepressant.
I guess this would be consistent with the generally accepted association.
I suffer from a rather severe and recalcitrant bipolar depression that exhibits the reverse diurnal pattern. The morning is my best time of day. MAOIs seem to help me more than SSRIs. Adding a tricyclic to the MAOI often produces a significant improvement, but it lasts for no more than a week. After it fades, it cannot be recaptured no matter how high the dosages of medication are pushed or how long I take them for. It really sucks to be me.
Any ideas?
I hope this was helpful.
- Scott
Posted by Jackd on August 10, 2002, at 12:32:48
In reply to Re: Parnate works sometimes..., posted by SLS on August 10, 2002, at 8:40:45
"He might be right. Even at the same dosage, there is often a saw-tooth pattern towards improvement. Up 2, down 1, up 2, etc. It might take a month at the right dosage before you see a discernable improvement, and 6 or more months to feel fantastic"
So is it normal to feel moody on it? I feel like I'm all over the place, cycling like crazy. I don't know if this is because I'm bipolar and this drug is destabilizing me like every other antidepressant I've tried or if I have to just stick it out. Is this agitation, too much energy, mood swing thing normal? Or am I becoming hypomanic? Are MAOIs particularly good and different in any way from other drugs when it comes to bipolars?
Posted by Rob829 on August 10, 2002, at 22:29:50
In reply to Re: Parnate works sometimes..., posted by SLS on August 10, 2002, at 8:40:45
Thanks for the posts guys...I have a question for SLS or maybe someone else who has taken Parnate. When you responded to 60 mg of Parnate, did you have a partial response to a lower dose, or did you just notice improvement starting at 60 mg?
Posted by cybercafe on August 11, 2002, at 5:19:38
In reply to Are MAOI's better for bipolar?, posted by Jackd on August 10, 2002, at 12:32:48
> So is it normal to feel moody on it? I feel like I'm all over the place, cycling like crazy. I don't know if this is because I'm bipolar and this drug is destabilizing me like every other antidepressant I've tried or if I have to just stick it out. Is this agitation, too much
Ug... quite the loaded question. It would totally depend on how much you "cycle" (full blown fatigue depression to full blown euphoric mania? or mood reactivity?) .... what causes the cycling... how much you cycle when not on meds... etc etc etc
>energy, mood swing thing normal? Or am I becoming hypomanic? Are MAOIs particularly good and different in any way from other drugs when it comes to bipolars?
MAOIs are better for bipolars than Tricyclics for sure. Some would say they are better than SSRIs, but I couldn't say that with any degree of certainty in general. In fact I don't remember anyone other than Himmelhoch that has studied MAOIs for bipolar depression off hand
personally i havn't gotten much hypomania (mainly just stimulant effects and now some non-stimulant antidepressant effects) from parnate, but i've totally been avoiding stress ... and i'm not much of a cycler/hypomanic to begin with
Posted by Jackd on August 12, 2002, at 12:53:04
In reply to Re: Are MAOI's better for bipolar?, posted by cybercafe on August 11, 2002, at 5:19:38
Just read the official definition of mood reactivity, and that definitely fits my description; irritablility, feelings of emptiness, uncontrollable anger, episodic dysphoria lasting only a few hours.
Nothing environmental seems to cause the cycling.
When not on meds I'm not really sure how much I cycle because I'm in such a haze and have such crappy memory. I think I cycle less, but am consistently more depressed.
I appreciate all the help guys.
This is the end of the thread.
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