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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Zoey1122 on November 20, 2004, at 7:21:07
Hello! I have been taking parnate for a couple months now and it has completely gotten rid of my depression :)! (As a sidenote, it did take 3 weeks to kick in!). In any case, I have horrible insomnia with it- I take 20mg in the morning and another 20mg by 3pm. My doctor prescribed Restoril and I am up to 45mg and I still wake up every night between 2-3am and cannot fall back asleep. Is anyone out there taking anything with Parnate that helps with a FULL night's sleep?? In addition, I take a very small dose of Abilify (5mg) in the morning so I don't think that is contributing to the insomnia. I appreciate any of your comments!!
Posted by djmmm on November 20, 2004, at 8:34:11
In reply to Parnate Insomniacs, posted by Zoey1122 on November 20, 2004, at 7:21:07
> Hello! I have been taking parnate for a couple months now and it has completely gotten rid of my depression :)! (As a sidenote, it did take 3 weeks to kick in!). In any case, I have horrible insomnia with it- I take 20mg in the morning and another 20mg by 3pm. My doctor prescribed Restoril and I am up to 45mg and I still wake up every night between 2-3am and cannot fall back asleep. Is anyone out there taking anything with Parnate that helps with a FULL night's sleep?? In addition, I take a very small dose of Abilify (5mg) in the morning so I don't think that is contributing to the insomnia. I appreciate any of your comments!!
>
>
>I have found that the only thing that works for me is melatonin. Ive tried Rx sleep meds like sonata, ambien, etc. with some success, but i was plagued with rebound insomnia the next night. My suggestion is that you try to take your second dose a little earlier..I take my 2nd dose @ noon.
Try giving melatonin a try, it's inexpensive and you can get it at any grocery store, I take anywhere between 6 and 15mg a night..
Posted by Dan Perkins on November 20, 2004, at 11:01:40
In reply to Re: Parnate Insomniacs, posted by djmmm on November 20, 2004, at 8:34:11
Melatonin didn't work for me but you should still probably try it first and use it if it does the trick for you.
Taking all my parnate (70mg) in a single dose in the morning helped with all my side effects, though it only helped a little bit w/insomnia.
The only way I was ever able to get a full night's sleep w/Parnate was by taking Trazodone. If the melatonin and earlier Parnate dosing don't help, Trazodone is worth a try.
Posted by King Vultan on November 20, 2004, at 11:22:50
In reply to Parnate Insomniacs, posted by Zoey1122 on November 20, 2004, at 7:21:07
Sleeping meds seem to be kind of hit and miss--what works well for one person might not work at all for another. I've tried melatonin in the past, and it seemed to have no real effects; I've also tried both trazodone and hyroxyzine with Parnate, and both kept me awake.
What has worked for me is a combination of certain sleep meds and sleep/relaxation CDs being played all night, such as those by Dr. Jeffrey Thompson. I believe I would be dead in the water if I didn't use both of these methods together. The med combination that I've finally found to be successful is to alternate between 0.25 mg Halcion/triazolam one night, and then use 5 mg Ambien + 25 mg Benadryl the next, then go back to the triazolam, etc. I found 10 mg Ambien by itself to do a poor job, and 50 mg Benadryl by itself gave me perhaps 3-6 hours of sleep. I seem to be able to get 7-8 hours using either of the med combinations I indicated, but without the sleep CDs, both are drastically less effective.
Todd
Posted by KaraS on November 20, 2004, at 14:05:47
In reply to Re: Parnate Insomniacs, posted by King Vultan on November 20, 2004, at 11:22:50
> Sleeping meds seem to be kind of hit and miss--what works well for one person might not work at all for another. I've tried melatonin in the past, and it seemed to have no real effects; I've also tried both trazodone and hyroxyzine with Parnate, and both kept me awake.
>
> What has worked for me is a combination of certain sleep meds and sleep/relaxation CDs being played all night, such as those by Dr. Jeffrey Thompson. I believe I would be dead in the water if I didn't use both of these methods together. The med combination that I've finally found to be successful is to alternate between 0.25 mg Halcion/triazolam one night, and then use 5 mg Ambien + 25 mg Benadryl the next, then go back to the triazolam, etc. I found 10 mg Ambien by itself to do a poor job, and 50 mg Benadryl by itself gave me perhaps 3-6 hours of sleep. I seem to be able to get 7-8 hours using either of the med combinations I indicated, but without the sleep CDs, both are drastically less effective.
>
> Todd
Todd,You can add in a sedating tricyclic with Parnate, can't you? I can't take benzos. I very quickly develop tolerance so that's not an option for me unfortunately. I've tried trazadone in the past and it made me very nauseous. I continued on it for between 2-3 months and it didn't get any better. Sedating tricyclics have worked well for me in the past although I don't look forward to the weight gain.
If I ever get the nerve up to try Parnate, I wonder if I would have problems sleeping. Knowing my situation, I wouldn't be surprised if it put me to sleep (at least until those autoreceptors got downregulated)... although I'm very sensitive to NE so maybe not. Only one way to find out I guess.
K
Posted by ed_uk on November 20, 2004, at 15:01:19
In reply to Re: Parnate Insomniacs » King Vultan, posted by KaraS on November 20, 2004, at 14:05:47
Zoey, do you have lormetazepam where you live? It lasts longer than temazepam so you are less likely to wake up in the night.
Ed
Posted by Zoey1122 on November 20, 2004, at 23:27:47
In reply to Re: Parnate Insomniacs, posted by ed_uk on November 20, 2004, at 15:01:19
Thank you all for your recommendations, I will look into them all!! And I will ask my psychiatrist about lormetazepam as well. I too have to listen to a meditation or sleep CD in order to fall asleep and I also will listen again in the middle of the night when I wake up. I agree they definitely help!
I was also wondering if my 40mg dose is too high. I'll talk to my doc about perhaps lowering to 30mg. Is that a similar to dose to all of you that take it? Does anyone else take Abilify (used as a stimulant as I was tired on Parnate originally)...
I tell you though, it's worth it not to be able to sleep then it would be to stop the drug and suffer depression again!
Posted by cubbybear on November 21, 2004, at 6:49:12
In reply to Re: Parnate Insomniacs, posted by Zoey1122 on November 20, 2004, at 23:27:47
As a long-time Parnate user who doesn't mind the reduced need for sleep time (I've never had serious insomnia with Parnate for a long period), I have a few things to add: First, I'm both surprised and intrigued to hear that one poster tried melatonin with Parnate and had no serious interaction. I had thought that the Parnate/melatonin combo was risky, since the latter raises serotonin levels. This was based on my extensive reading about melatonin.
As for me, I'm currently taking 30 mg. Parnate as a maintenance dose and think it's worth a try to decrease your dose from 40 mg. to 30 mg. if insomnia is a problem.
One drug that may be safely taken with Parnate is Neurontin and I've found that as little as 300 mg. can pretty much knock me out, although I have to contend with morning drowsiness.
Formerly, I had taken 3-4 mg. of Klonopin as a sleeping aid, but the drawback to this is that any benzo drug taken for an extended period puts you in the position of getting habituated.
As for music, I recommend: "Sleep Soundly" (forgot the producer's name), Buddhist chants, Native American flute music, and an anthology of relaxing classical compositions entitled "Dream Children."
Hope all of this helps.
Posted by King Vultan on November 21, 2004, at 10:04:54
In reply to Re: Parnate Insomniacs » King Vultan, posted by KaraS on November 20, 2004, at 14:05:47
>
>
> Todd,
>
> You can add in a sedating tricyclic with Parnate, can't you? I can't take benzos. I very quickly develop tolerance so that's not an option for me unfortunately. I've tried trazadone in the past and it made me very nauseous. I continued on it for between 2-3 months and it didn't get any better. Sedating tricyclics have worked well for me in the past although I don't look forward to the weight gain.
>
I'm convinced that Surmontil (trimipramine) is completely safe to use with an MAOI, as it neither blockades amine reuptake nor releases amines through some other mechanism, such as an alpha-2 adrenergic blockade. I also think that doxepin is probably relatively safe to use with MAOIs because while it does blockade both serotonin and NE reuptake, these effects are relatively weak compared to its ridiculously strong histamine blockade. As for amitriptyline, I've heard of people using this with MAOIs, but it is too strong at blockading serotonin and norepinephrine reuptake for me to be comfortable using it personally.Todd
Posted by sfy on November 21, 2004, at 12:21:28
In reply to Re: Parnate Insomniacs » KaraS, posted by King Vultan on November 21, 2004, at 10:04:54
Mirtazapine supposedly is also safe to take with Parnate and can prove an effective sleep aid for some.
Posted by KaraS on November 21, 2004, at 16:08:04
In reply to Re: Parnate Insomniacs » KaraS, posted by King Vultan on November 21, 2004, at 10:04:54
Posted by Zoey1122 on November 21, 2004, at 18:19:56
In reply to Re: Parnate Insomniacs, posted by sfy on November 21, 2004, at 12:21:28
Posted by cubbybear on November 22, 2004, at 9:05:40
In reply to Re: Parnate Insomniacs, posted by sfy on November 21, 2004, at 12:21:28
> Mirtazapine supposedly is also safe to take with Parnate and can prove an effective sleep aid for some.
I think you're talking about Remeron, and if that's the case, I'm almost sure I read in various sources that Remeron/Parnate can create a serious problem. So I'll add a strong note of "better check this out further!"
Posted by sfy on November 22, 2004, at 12:20:46
In reply to Re: Parnate Insomniacs » sfy, posted by cubbybear on November 22, 2004, at 9:05:40
> I think you're talking about Remeron, and if that's the case, I'm almost sure I read in various sources that Remeron/Parnate can create a serious problem. So I'll add a strong note of "better check this out further!"
>
>
That's what I thought until I came across this article: http://www.currentpsychiatry.com/2002_06/06_02_maoi.asp which references this letter on using mirtazapine for serotonin syndrome:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8741027But I do agree that it bears more investigation.
Posted by cubbybear on November 23, 2004, at 0:55:05
In reply to Re: Parnate Insomniacs » cubbybear, posted by sfy on November 22, 2004, at 12:20:46
> > I think you're talking about Remeron, and if that's the case, I'm almost sure I read in various sources that Remeron/Parnate can create a serious problem. So I'll add a strong note of "better check this out further!"
> >
> >
> That's what I thought until I came across this article: http://www.currentpsychiatry.com/2002_06/06_02_maoi.asp which references this letter on using mirtazapine for serotonin syndrome:
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8741027
>
> But I do agree that it bears more investigation.I've already read the first article (Current Psychiatry) and was quite surprised when I saw the authors claim that Mirtazapine was OK with MAOIs.
This is a major problem--and I'd say a serious problem in the field--when one professional researcher states that A can be safely taken with B, while another researcher states that A is dangerous with B, while the manufacturer of course, clearly states on the patient insert that the combination of A & B could be life-threatening.
How did the first researcher arrive at his/her conclusion? Is he basing his info solely on one or two cases where the patients somehow suffered no adverse reaction? We don't know.
I always want to err on the side of caution. This kind of conflicting data points up how much of psychopharmacology remains flawed and questionable.
This is the end of the thread.
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