Posted by SLS on July 21, 2003, at 18:07:07
In reply to Re: want to stop taking Parnate, posted by TJO on July 21, 2003, at 18:01:58
I mistakenly posted using the name of another person who uses the same computer.
- Scott> > I started taking Parnate a couple of years ago. Eventually went up to 90 mg. It worked okay for a while then seemed to 'poop' out'. Pdoc added lithium, could not take the side effects. Started augmenting with Lamitcal. When I reached 150 mg. I felt better than I have in my whole life. This wonderful feeling only lasted 2 weeks. Pdoc upped dose to 300 Mg, will be there next week, but have not had same response.
>
> Hi.
>
> I have heard of people needing 300mg of Parnate. It is rare, though. Jay Amsterdam, MD at the University of Pennsylvania, has advocated this strategy for many years. I myself have been up to 150mg.
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> What drugs have you combined with Parnate? Have you tried either Nardil or Effexor?
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> > I am also losing so much hair, I won't have any left soon.
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> > My understanding is that Lamitcal does not cause hair loss.
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> Lamictal caused me both hair loss and terrible dandruff. Using an antidandruff shampoo containing zinc pyrithione completely resolved the situation. I've never seen anyone else describe hair loss with Parnate.
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> > My pdoc is away for 3 weeks, I don't have an appt. until Aug. 14. My panic is, that I am returning to work last week in August after a 2 1/2 sick leave. I have taken it upon myself to go down 10 mg a week, now down to 70mg. and to keep taking the Lamitcal. I am terrified to to work while I am feeling depressed, like I am.
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> > 1. Do you think going off Parnate is a bad decision?
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> I think the answer to that question might depend upon how many drugs you have failed to respond to. It might not be a bad idea to remain at 60-80mg and try adding another drug to it. Many doctors favor adding lithium to Parnate. I have had success adding desipramine to it. Be aware, however, that you cannot add an SSRI, Effexor, or Anafranil to it.
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> You are in a difficult situation with work, and I wish I knew exactly what treatment would work for you. Unfortunately, finding the right medications is often trial-and-error. Most doctors require that one wait 2 weeks between the last dose of Parnate and the first dose of an alternate medication. Added to the time it takes to wean off Parnate, this would mean that you cannot expect to gain an improvement with a new drug for at least 6 weeks.
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> 2 weeks weaning
> 2 weeks washout
> 2 weeks wait for response to new drug
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> It is a gamble. Were it to work, raising the dosage of Parnate or adding medication to augmenting it would get you feeling better before going back to work. I wouldn't want to offer you a specific recommendation. Any decision making process should take into consideration your treatment history.
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>
> - Scott
>
poster:SLS
thread:243970
URL: http://www.dr-bob.org/babble/20030718/msgs/244047.html