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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by shasling on October 28, 2009, at 17:32:40
Being on parnate over five years,having both the good times and the poop outs here are some basic things i personaly notice,
-- Expect to have to augment parnate in short time,both for a better ANTI DEPRESSANT effect as well as for residue anxiety and mania,i.e benzo or mood stablizer.Common parnate user,PARNATE,BENZO/MOOD STABLIZER/STIMULANT
Expect to require high doses to achieave and maintain effect..i.e 60-120 mg range,anything under can work however can also very well be a reason it doesent,with p docs the way they are,its often difficult to even get to the 60 mg range,so u see many people latly failing,its a shame,sometimes u have to take initiative to get to that dose with or without your doc,but under at least 60 mg is giving the med a good chance to fail.
--- Expect insomnia,its usualy not a fading side effect,so like scott says attack it vigoursly.Personaly i did not achieve consecutive sleep until i added zanaflex a light muscle relaxant,i cycle off however its not a med known for addiction.I also use Zonegran a gaba acting off label mood stablizer.
--- Last expect daytime fatique,DO NOT ATTEMPT to fix this with more parnate,best thing i found for it is a simple caffiene tab i.e VIVARIN 250 pure caffiene at your local 7 eleven.Its hard to type exactly what i want to share,but this is just a jift of it,feel free to ask if you have any questions,im on parnate now and havent changed due to i see no options out to switch and try,i believe all srris are somewhat similiar,and ssNRIS although better still dont seem to make me feel more confident in leaving parnate.
Posted by bulldog2 on October 28, 2009, at 17:41:27
In reply to Notes about parnate....., posted by shasling on October 28, 2009, at 17:32:40
> Being on parnate over five years,having both the good times and the poop outs here are some basic things i personaly notice,
>
>
> -- Expect to have to augment parnate in short time,both for a better ANTI DEPRESSANT effect as well as for residue anxiety and mania,i.e benzo or mood stablizer.
>
> Common parnate user,PARNATE,BENZO/MOOD STABLIZER/STIMULANT
>
> Expect to require high doses to achieave and maintain effect..i.e 60-120 mg range,anything under can work however can also very well be a reason it doesent,with p docs the way they are,its often difficult to even get to the 60 mg range,so u see many people latly failing,its a shame,sometimes u have to take initiative to get to that dose with or without your doc,but under at least 60 mg is giving the med a good chance to fail.
>
>
> --- Expect insomnia,its usualy not a fading side effect,so like scott says attack it vigoursly.Personaly i did not achieve consecutive sleep until i added zanaflex a light muscle relaxant,i cycle off however its not a med known for addiction.
>
> I also use Zonegran a gaba acting off label mood stablizer.
>
>
> --- Last expect daytime fatique,DO NOT ATTEMPT to fix this with more parnate,best thing i found for it is a simple caffiene tab i.e VIVARIN 250 pure caffiene at your local 7 eleven.
>
> Its hard to type exactly what i want to share,but this is just a jift of it,feel free to ask if you have any questions,im on parnate now and havent changed due to i see no options out to switch and try,i believe all srris are somewhat similiar,and ssNRIS although better still dont seem to make me feel more confident in leaving parnate.1. do you like low dose nortriptyline with parnate?
2. I use neurontin 1200 mg 2 times for anti-anxiety and a mild ad effect. Should I use this with parnate or use another mood stabilizer
3. Dr. Goldberg said to stay at the max dose parnate for eight weeks to see if it works. What was your experience?
4. I titrated parnate to 60 mg over an eight week period. Was at 60 mg 10 days and stopped due to an adequate response
Posted by emmanuel98 on October 28, 2009, at 18:29:42
In reply to Re: Notes about parnate....., posted by bulldog2 on October 28, 2009, at 17:41:27
For those considering parnate, I should say that I started it at 30mg and my depression was gone within 48 hours and has stayed gone after two months. I had no daytime drowsiness. A little orthostatic hypotension which resolved within weeks. Insomnia which was cured by adding 100mg seroquel. So not everybody should expect major problems with parnate. For me it has worked wonders.
Posted by bulldog2 on October 28, 2009, at 18:29:49
In reply to Notes about parnate....., posted by shasling on October 28, 2009, at 17:32:40
> Being on parnate over five years,having both the good times and the poop outs here are some basic things i personaly notice,
>
>
> -- Expect to have to augment parnate in short time,both for a better ANTI DEPRESSANT effect as well as for residue anxiety and mania,i.e benzo or mood stablizer.
>
> Common parnate user,PARNATE,BENZO/MOOD STABLIZER/STIMULANT
>
> Expect to require high doses to achieave and maintain effect..i.e 60-120 mg range,anything under can work however can also very well be a reason it doesent,with p docs the way they are,its often difficult to even get to the 60 mg range,so u see many people latly failing,its a shame,sometimes u have to take initiative to get to that dose with or without your doc,but under at least 60 mg is giving the med a good chance to fail.
>
>
> --- Expect insomnia,its usualy not a fading side effect,so like scott says attack it vigoursly.Personaly i did not achieve consecutive sleep until i added zanaflex a light muscle relaxant,i cycle off however its not a med known for addiction.
>
> I also use Zonegran a gaba acting off label mood stablizer.
>
>
> --- Last expect daytime fatique,DO NOT ATTEMPT to fix this with more parnate,best thing i found for it is a simple caffiene tab i.e VIVARIN 250 pure caffiene at your local 7 eleven.
>
> Its hard to type exactly what i want to share,but this is just a jift of it,feel free to ask if you have any questions,im on parnate now and havent changed due to i see no options out to switch and try,i believe all srris are somewhat similiar,and ssNRIS although better still dont seem to make me feel more confident in leaving parnate.Does the hypotension disappear?
Posted by emmanuel98 on October 28, 2009, at 19:08:27
In reply to Re: Notes about parnate....., posted by bulldog2 on October 28, 2009, at 18:29:49
>How did the hypotension disappear?
It just did. I still get a little when I get up in the morning or the middle of the night, but I just sit for a minute or two and wait for my blood pressure to normalize. I wore special stockings for a few weeks to keep blood from pooling in my legs, but I found that I didn't need them. I should add that I am on a relatively low dose (10mg tid) of parnate compared to others on this site. 30mg has been enough for me. The side effects have been so minor that it feels to me like taking a vitamin every day.
Posted by g_g_g_unit on October 28, 2009, at 19:22:44
In reply to Re: Notes about parnate....., posted by emmanuel98 on October 28, 2009, at 19:08:27
> >How did the hypotension disappear?
>
> It just did. I still get a little when I get up in the morning or the middle of the night, but I just sit for a minute or two and wait for my blood pressure to normalize. I wore special stockings for a few weeks to keep blood from pooling in my legs, but I found that I didn't need them. I should add that I am on a relatively low dose (10mg tid) of parnate compared to others on this site. 30mg has been enough for me. The side effects have been so minor that it feels to me like taking a vitamin every day.do you still use the Seroquel to sleep?
Posted by emmanuel98 on October 28, 2009, at 19:30:59
In reply to Re: Notes about parnate....., posted by g_g_g_unit on October 28, 2009, at 19:22:44
>do you still use Seroquel to sleep?
I do, though I may be okay without it. The parnate insomnia was awful, as Maxine has experienced. I went 72 hours without sleep at one point. I'm an insomniac from way back and hate it. Before I went on parnate, I took 150mg of trazadone every night, whether I needed it or not. Since trazadone is contraindicated with Parnate, I went to seroquel instead. I don't have any ill effects from it. It doesn't make me gain weight. I feel rested and alert in the mornings.I posted this about parnate because I had tried everything -- including ECT -- for severe suicidal depression with pyschotic features and was ready to give up. Parnate has given me my life back.
Posted by willyeee on October 28, 2009, at 21:43:20
In reply to Re: Notes about parnate....., posted by bulldog2 on October 28, 2009, at 17:41:27
> > Being on parnate over five years,having both the good times and the poop outs here are some basic things i personaly notice,
> >
> >
> > -- Expect to have to augment parnate in short time,both for a better ANTI DEPRESSANT effect as well as for residue anxiety and mania,i.e benzo or mood stablizer.
> >
> > Common parnate user,PARNATE,BENZO/MOOD STABLIZER/STIMULANT
> >
> > Expect to require high doses to achieave and maintain effect..i.e 60-120 mg range,anything under can work however can also very well be a reason it doesent,with p docs the way they are,its often difficult to even get to the 60 mg range,so u see many people latly failing,its a shame,sometimes u have to take initiative to get to that dose with or without your doc,but under at least 60 mg is giving the med a good chance to fail.
> >
> >
> > --- Expect insomnia,its usualy not a fading side effect,so like scott says attack it vigoursly.Personaly i did not achieve consecutive sleep until i added zanaflex a light muscle relaxant,i cycle off however its not a med known for addiction.
> >
> > I also use Zonegran a gaba acting off label mood stablizer.
> >
> >
> > --- Last expect daytime fatique,DO NOT ATTEMPT to fix this with more parnate,best thing i found for it is a simple caffiene tab i.e VIVARIN 250 pure caffiene at your local 7 eleven.
> >
> > Its hard to type exactly what i want to share,but this is just a jift of it,feel free to ask if you have any questions,im on parnate now and havent changed due to i see no options out to switch and try,i believe all srris are somewhat similiar,and ssNRIS although better still dont seem to make me feel more confident in leaving parnate.
>
> 1. do you like low dose nortriptyline with parnate?
> 2. I use neurontin 1200 mg 2 times for anti-anxiety and a mild ad effect. Should I use this with parnate or use another mood stabilizer
> 3. Dr. Goldberg said to stay at the max dose parnate for eight weeks to see if it works. What was your experience?
> 4. I titrated parnate to 60 mg over an eight week period. Was at 60 mg 10 days and stopped due to an adequate responseSorry was on friends pc and dident notice my post went under her name.I posted and to respond,
--- First gabpentin works fine with parnate,eithe as a add on for sleep,or for anxiety,or mood stablization.HOWEVER high doses of it i find will greatly change the affect of parnate,the mix will cause a weird state or feel,.....the high dose taken at night avoided this but taking high dose nuerontion in the day along with parnate again ruined or lessened parnates benifit for me.
Most moos stablizers work similiar,on gaba,so id personaly try to use the higher doses of any one of them at night and lower ones in the day as they all,being highly sedative seem to effect parnate and may lessen its benifit.Of course if u are actualy having mid day rage and need it take it then.
Far as which one to use,everyone has there one that works,example i HATE lamictal,many many people use it with parnate...i myself use nuerontion and zonegran which seem to be helping.
--- Nortrip seems to be popular to add,i did for a short time but dident find benifit,however like u i see more then enough use of the two to believe they must have some good synergy,also hear modfanil has ok synergy with parnate as well.
--- I dont read any more studies,user accounts here from veterans like scott and other maoi long time users i find more valuable,as i said you have the few lucky enough to get by on very low doses such as 30 mg a day,and you have treatment resistent like me who should go at the very least 60 mg,and if tolerated up to 150......doses for treatment resistant have been limited and used often at the 200 mg range.
Posted by willyeee on October 28, 2009, at 21:45:06
In reply to Re: Notes about parnate....., posted by bulldog2 on October 28, 2009, at 17:41:27
> > Being on parnate over five years,having both the good times and the poop outs here are some basic things i personaly notice,
> >
> >
> > -- Expect to have to augment parnate in short time,both for a better ANTI DEPRESSANT effect as well as for residue anxiety and mania,i.e benzo or mood stablizer.
> >
> > Common parnate user,PARNATE,BENZO/MOOD STABLIZER/STIMULANT
> >
> > Expect to require high doses to achieave and maintain effect..i.e 60-120 mg range,anything under can work however can also very well be a reason it doesent,with p docs the way they are,its often difficult to even get to the 60 mg range,so u see many people latly failing,its a shame,sometimes u have to take initiative to get to that dose with or without your doc,but under at least 60 mg is giving the med a good chance to fail.
> >
> >
> > --- Expect insomnia,its usualy not a fading side effect,so like scott says attack it vigoursly.Personaly i did not achieve consecutive sleep until i added zanaflex a light muscle relaxant,i cycle off however its not a med known for addiction.
> >
> > I also use Zonegran a gaba acting off label mood stablizer.
> >
> >
> > --- Last expect daytime fatique,DO NOT ATTEMPT to fix this with more parnate,best thing i found for it is a simple caffiene tab i.e VIVARIN 250 pure caffiene at your local 7 eleven.
> >
> > Its hard to type exactly what i want to share,but this is just a jift of it,feel free to ask if you have any questions,im on parnate now and havent changed due to i see no options out to switch and try,i believe all srris are somewhat similiar,and ssNRIS although better still dont seem to make me feel more confident in leaving parnate.
>
> 1. do you like low dose nortriptyline with parnate?
> 2. I use neurontin 1200 mg 2 times for anti-anxiety and a mild ad effect. Should I use this with parnate or use another mood stabilizer
> 3. Dr. Goldberg said to stay at the max dose parnate for eight weeks to see if it works. What was your experience?
> 4. I titrated parnate to 60 mg over an eight week period. Was at 60 mg 10 days and stopped due to an adequate responseSorry was on friends pc and dident notice my post went under her name.I posted and to respond,
--- First gabpentin works fine with parnate,eithe as a add on for sleep,or for anxiety,or mood stablization.HOWEVER high doses of it i find will greatly change the affect of parnate,the mix will cause a weird state or feel,.....the high dose taken at night avoided this but taking high dose nuerontion in the day along with parnate again ruined or lessened parnates benifit for me.
Most moos stablizers work similiar,on gaba,so id personaly try to use the higher doses of any one of them at night and lower ones in the day as they all,being highly sedative seem to effect parnate and may lessen its benifit.Of course if u are actualy having mid day rage and need it take it then.
Far as which one to use,everyone has there one that works,example i HATE lamictal,many many people use it with parnate...i myself use nuerontion and zonegran which seem to be helping.
--- Nortrip seems to be popular to add,i did for a short time but dident find benifit,however like u i see more then enough use of the two to believe they must have some good synergy,also hear modfanil has ok synergy with parnate as well.
--- I dont read any more studies,user accounts here from veterans like scott and other maoi long time users i find more valuable,as i said you have the few lucky enough to get by on very low doses such as 30 mg a day,and you have treatment resistent like me who should go at the very least 60 mg,and if tolerated up to 150......doses for treatment resistant have been limited and used often at the 200 mg range.
Posted by willyeee on October 28, 2009, at 21:52:46
In reply to Re: Notes about parnate....., posted by emmanuel98 on October 28, 2009, at 18:29:42
> For those considering parnate, I should say that I started it at 30mg and my depression was gone within 48 hours and has stayed gone after two months. I had no daytime drowsiness. A little orthostatic hypotension which resolved within weeks. Insomnia which was cured by adding 100mg seroquel. So not everybody should expect major problems with parnate. For me it has worked wonders.
First let me say glad you had/have success!Second i envy you on not having day time fatigue,if you follow parnate posts you can see its a very common problem with many many users.
You also napped the insomnia easly,something not every user is able to do,for some,it takes many attacks at it but its great when someone finds the answer in a short time.
Last in case i dident mention,i also believe it can be a life safer,its a shame people in extreme need of help are shifted from ssri to ssri which by common sense work a ver similiar way leaving little room for success,OVER instead trying a maoi,a med with good success rates and different pharmocolgy to that person.
I know after at least 15 non stop ssri failures my response to parnate happened on day 3
Posted by willyeee on October 28, 2009, at 22:02:49
In reply to Re: Notes about parnate....., posted by bulldog2 on October 28, 2009, at 18:29:49
Also FYI since in stores like walgreens etc they are EXPENSIVE,instead go to google,once there go to google MORE and when it opens the second page look for PRODUCT SEARCH.
Scan for a blood Pressure Cuff,a small home unit blood pressue monitor.I actualy have one named PREVENTION MODEL DS-2200 which cost me 20 dollers!!!
At most they cost 50 dollers,its been great we have used it many times when i have not felt well its great to have close by,you can also just type in the model and name in normal google as well,i recomend it.
Posted by g_g_g_unit on October 28, 2009, at 22:10:23
In reply to Re: Notes about parnate....., posted by emmanuel98 on October 28, 2009, at 19:30:59
> >do you still use Seroquel to sleep?
> I do, though I may be okay without it. The parnate insomnia was awful, as Maxine has experienced. I went 72 hours without sleep at one point. I'm an insomniac from way back and hate it. Before I went on parnate, I took 150mg of trazadone every night, whether I needed it or not. Since trazadone is contraindicated with Parnate, I went to seroquel instead. I don't have any ill effects from it. It doesn't make me gain weight. I feel rested and alert in the mornings.
>
> I posted this about parnate because I had tried everything -- including ECT -- for severe suicidal depression with pyschotic features and was ready to give up. Parnate has given me my life back.Seroquel works but gives me the worst sinus-headaches. i use imovane, but i have to take a lot, and don't want to end up addicted. i tried going without it and barely slept for five days. unfortunately, the insomnia hasn't passed after 10 weeks, so i'm probably gonna come off. it hasn't helped my depression anyway.
Posted by SheilaC on October 29, 2009, at 10:09:46
In reply to Re: Notes about parnate....., posted by emmanuel98 on October 28, 2009, at 18:29:42
> For those considering parnate, I should say that I started it at 30mg and my depression was gone within 48 hours and has stayed gone after two months. I had no daytime drowsiness. A little orthostatic hypotension which resolved within weeks. Insomnia which was cured by adding 100mg seroquel. So not everybody should expect major problems with parnate. For me it has worked wonders.
I've considered Parnate but was afraid of the food interactions. I like to have a glass of wine, eat chocolate and cheese. Do I have to worry about this on a small dose of Parnate?
Posted by emmanuel98 on October 29, 2009, at 10:42:33
In reply to Re: Notes about parnate....., posted by SheilaC on October 29, 2009, at 10:09:46
Chocolate is not a problem. White wine (in small doses is not a problem. You need to cut out cheese. However, I have tried putting just a couple of tablespoons of grated parmesan on pasta so far with no ill effect. The dietary restrictions are really pretty minimal.
> I've considered Parnate but was afraid of the food interactions. I like to have a glass of wine, eat chocolate and cheese. Do I have to worry about this on a small dose of Parnate?
>
>
Posted by bulldog2 on October 29, 2009, at 12:24:57
In reply to Re: Notes about parnate....., posted by willyeee on October 28, 2009, at 21:43:20
> > > Being on parnate over five years,having both the good times and the poop outs here are some basic things i personaly notice,
> > >
> > >
> > > -- Expect to have to augment parnate in short time,both for a better ANTI DEPRESSANT effect as well as for residue anxiety and mania,i.e benzo or mood stablizer.
> > >
> > > Common parnate user,PARNATE,BENZO/MOOD STABLIZER/STIMULANT
> > >
> > > Expect to require high doses to achieave and maintain effect..i.e 60-120 mg range,anything under can work however can also very well be a reason it doesent,with p docs the way they are,its often difficult to even get to the 60 mg range,so u see many people latly failing,its a shame,sometimes u have to take initiative to get to that dose with or without your doc,but under at least 60 mg is giving the med a good chance to fail.
> > >
> > >
> > > --- Expect insomnia,its usualy not a fading side effect,so like scott says attack it vigoursly.Personaly i did not achieve consecutive sleep until i added zanaflex a light muscle relaxant,i cycle off however its not a med known for addiction.
> > >
> > > I also use Zonegran a gaba acting off label mood stablizer.
> > >
> > >
> > > --- Last expect daytime fatique,DO NOT ATTEMPT to fix this with more parnate,best thing i found for it is a simple caffiene tab i.e VIVARIN 250 pure caffiene at your local 7 eleven.
> > >
> > > Its hard to type exactly what i want to share,but this is just a jift of it,feel free to ask if you have any questions,im on parnate now and havent changed due to i see no options out to switch and try,i believe all srris are somewhat similiar,and ssNRIS although better still dont seem to make me feel more confident in leaving parnate.
> >
> > 1. do you like low dose nortriptyline with parnate?
> > 2. I use neurontin 1200 mg 2 times for anti-anxiety and a mild ad effect. Should I use this with parnate or use another mood stabilizer
> > 3. Dr. Goldberg said to stay at the max dose parnate for eight weeks to see if it works. What was your experience?
> > 4. I titrated parnate to 60 mg over an eight week period. Was at 60 mg 10 days and stopped due to an adequate response
>
> Sorry was on friends pc and dident notice my post went under her name.I posted and to respond,
>
> --- First gabpentin works fine with parnate,eithe as a add on for sleep,or for anxiety,or mood stablization.HOWEVER high doses of it i find will greatly change the affect of parnate,the mix will cause a weird state or feel,.....the high dose taken at night avoided this but taking high dose nuerontion in the day along with parnate again ruined or lessened parnates benifit for me.
>
> Most moos stablizers work similiar,on gaba,so id personaly try to use the higher doses of any one of them at night and lower ones in the day as they all,being highly sedative seem to effect parnate and may lessen its benifit.Of course if u are actualy having mid day rage and need it take it then.
>
> Far as which one to use,everyone has there one that works,example i HATE lamictal,many many people use it with parnate...i myself use nuerontion and zonegran which seem to be helping.
>
>
> --- Nortrip seems to be popular to add,i did for a short time but dident find benifit,however like u i see more then enough use of the two to believe they must have some good synergy,also hear modfanil has ok synergy with parnate as well.
>
>
> --- I dont read any more studies,user accounts here from veterans like scott and other maoi long time users i find more valuable,as i said you have the few lucky enough to get by on very low doses such as 30 mg a day,and you have treatment resistent like me who should go at the very least 60 mg,and if tolerated up to 150......doses for treatment resistant have been limited and used often at the 200 mg range.As you titrate up how long do you stay at each dosage before you decide it's time to move up.
I'm glad the hypotension resolves. Im in rehab for a hip replacement and don't need to fall down.
Posted by FredPotter on October 29, 2009, at 15:54:31
In reply to Re: Notes about parnate..... » willyeee, posted by bulldog2 on October 29, 2009, at 12:24:57
I've been on several doses but now I'm trying to stay on 40mg Parnate for at least 4 weeks. The hypotension as gone, which concerns me, as it is supposed to be a sign that MAO is being blocked. My main problems are drowsiness in the day coupled with an inner agitation. My legs think they're asleep. I've read that Parnate produces melatonin so this would explain the sleepiness. I sleep OK at night with the help of 50mg nortriptyline. If one stays on alower dose like 20 or 30 does one still get there eventually?
Thanks Fred
Posted by willyeee on October 29, 2009, at 16:06:59
In reply to Re: Notes about parnate..... » willyeee, posted by bulldog2 on October 29, 2009, at 12:24:57
I dont want my experiance or method to confuse anyone,its an inidvidual thing and its important to feel the dose as you raise it and be careful.
Perhaps since im on it long,when its not working i titrate quickly in a matter of 2-3 days ill go from 80 mg to 150 mg,once stable ill titrate back down.
But i make sure i listen to my body,this for me is more important then a doc doing it or anyone else,i just make sure i respect the drug but i do move fast.
Posted by Maxime on October 29, 2009, at 16:42:53
In reply to Re: Notes about parnate....., posted by FredPotter on October 29, 2009, at 15:54:31
I'm lucky, I don't have to spread my dosage over the day. I take it all at once otherwise I forget to take the second dosage.
Posted by Maxime on October 29, 2009, at 16:43:46
In reply to Re: Notes about parnate....., posted by SheilaC on October 29, 2009, at 10:09:46
Even if you are on a small dosage of Parnate you have to worry about food interactions. You can't escape them.
Posted by FredPotter on November 4, 2009, at 14:26:05
In reply to Re: Notes about parnate..... » SheilaC, posted by Maxime on October 29, 2009, at 16:43:46
Maxime don't you feel drowsy? It's such a problem for me as I'm trying to hold down a job
Fred
Posted by Defective on May 18, 2011, at 15:54:02
In reply to Re: Notes about parnate....., posted by bulldog2 on October 28, 2009, at 18:29:49
Hi, I saw your messages on the Dr. Bob board and I was wondering if you could please answer a quick question. I started Parnate 13 days ago, day 1 I took 20 mg, day 2-8 I I took 30 mg, day 10-11 I took 40 mg, and the last two days I've been on 50 mg. I haven't felt anything yet and I was instructed to go up to 60 tomorrow. Based on your experience and others on the message board, when would you expect me to feel an anti-depressant response? Thanks in advance for any advice you may have to share with me.
Best,
Defective
This is the end of the thread.
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