Posted by King Vultan on December 29, 2004, at 20:39:32
In reply to About high-dose Parnate treatment, posted by jparsell82` on December 28, 2004, at 19:03:18
> I've read Chairman_Mao's information and experience about high dose Parnate and the 1989 study on pubmed.org. Anyways, is anybody on Parnate here considering trying this out? Chairman_Mao made it sound really good. Especially because I don't think there are a whole lot of good drugs you can augment Parnate with for Social Phobia, Depression, and ADD. Anyone asked their doctor about trying it? I think it would be hard for me to find a doctor willing to try this. I know of a really cheap Parnate source on the internet but even still it would cost nearly $150 to take 100mg/daily. And I don't know how high you would need to go...
I've been on Parnate since August and at 60 mg/day for about 6 weeks now. I am doing reasonably well but am not quite where I want to be moodwise and in a few other areas; for instance, my libido is still very much on the low side, which is surprising in view of Parnate clearly being quite dopaminergic. In thinking this all over, and considering my reactions to the other umpteen drugs I've taken, I believe that one thing that is occurring is that I am suffering some serotonergic related side effects from the Parnate increasing serotonin transmission. It would seem that one of my fundamental problems may be that I simply have too many 5-HT2A receptors, given the severity of the insomnia and certain other side effects I've suffered taking SSRIs.So rather than ask my pdoc to increase my Parnate dosage at this point in time, I've decided to pursue an augmentative strategy of adding a 5-HT2A blockader to see if my thoughts on this may be correct. Risperdal at low dosages (0.5-1.0 mg/day) is apparently the most selective 5-HT2A antagonist available, and my pdoc was quite aware of the potential benefits in using this kind of agent to augment drugs that increase serotonin transmission. I started at 0.125 mg/day for six days and just went up to 0.25 mg/day a few days ago. Even at this extremely low dosage, I'm already noticing some improvements, particularly, in the area of agitation and racing thoughts. I have a tendency when I read or think for my thoughts to get ahead of themselves, resulting in a certain amount of agitation and anxiety. I can already tell that the Risperdal is having some beneficial effects in this area, and I have not noticed any side effects as of yet. I think 0.5 mg/day is probably a good target to shoot for at this point, as I also have some concern about getting too high in dosage and starting to blockade substantial amounts of dopamine D2 receptors, which I certainly don't need given my ADD symptoms and anhedonia, as well as my general lack of any psychotic or manic symptoms.
So in my case, while I think it might make sense to go up on the Parnate in the future, particularly given the large improvement I noticed in drive and motivation going from 50 to 60 mg/day, it just seemed to make far more sense to try to augment it with something else at this point in time. My opinion and experience is that especially when you are already at a high dose of a drug, it may make more sense to explore possible synergistic effects with other drugs rather than just throwing more and more of the main drug at it.
Todd
poster:King Vultan
thread:435178
URL: http://www.dr-bob.org/babble/20041228/msgs/435495.html