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
poster:SLS
thread:115881
URL: http://www.dr-bob.org/babble/20020807/msgs/115923.html