Posted by King Vultan on September 5, 2004, at 11:21:02
In reply to Re: Parnate to Cymbalta?, posted by quarterwit on September 5, 2004, at 9:22:44
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> BTW, why did you go off the Parnate? Also, any suggestions on how to spread out dose once it gets to 60? How about 30 in morning, 30 early afternoon? A weird effect so far for me is that once I hit >20, taking 10 mg in singles made me drowsy, but if I took 20 at once I got some perkiness. In the past Dexedrine did same thing: low doses got me tired, and I needed higher doses spread through day to get any positive effects. Thanks, Scott
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This makes me think of an issue that was being discussed recently about certain people who get sleepy upon administration of stimulant type drugs. The hypothesis proposed was that these people may have hypersensitive dopamine autoreceptors, that is, too many inhibitory receptors keeping dopamine transmission at a chronically low level, and which may also tend to slow or shut down the firing rate of the dopamine neuron if there is any extra dopamine around, as what happens when taking a stimulant. If this does happen to be the case with you, in theory, anyway, Parnate has a good chance of ultimately working, as the hope would be that the extra dopamine available from its inhibition of MAO-B added to that from its stimulant effect may be enough in total to downregulate, or reduce in number, the inhibitory autoreceptors. The end result would be that the neuron's firing rate would speed up to normal and relieve your symptoms.Unfortunately, I don't know how long this downregulation process, if it occurs, winds up taking. I have some of the same issues as you, as some drugs such as Provigil have made me paradoxically sleepy. Like you, I have also just started Parnate and am wondering what kind of time frame will be involved for the full therapeutic effects to be apparent. In my case, I seem to be tolerating it somewhat better, as I can't really say that it's made me sleepy; however, it does seem to be making me a bit more depressed at times. Again, this could perhaps involve some of the same autoreceptor hypersensitivity issues--it's really hard to say for sure what exactly is going on. I have noticed a big improvement in cognitive function, at least. This is my 5th day on 30 mg/day; I was on 20 mg/day for a week before that. I'll soon be making an appointment to see my pdoc about going up to 40 mg/day but am not really doing all that bad on 30--well, depending on the day, anyway.
Todd
poster:King Vultan
thread:386419
URL: http://www.dr-bob.org/babble/20040904/msgs/386665.html