Posted by Vincent_QC on January 24, 2009, at 16:48:43
In reply to How to Augment Parnate for social-anx + anhedonia?, posted by AdamCanada2 on January 23, 2009, at 16:40:30
> I take currently 15mg parnate divided 10mg early in day and 5mg later on. I also take Valium 5mg twice a day.
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> I may try 20mg Parnate as I have in the past but at those doses I begin to have a lot of hypotension/dizziness and cloudy mind... not to mention increased insomnia.
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> I notice after 2-3 weeks on 15mg parnate I am starting to sleep better (maybe 6-7 hours) on average instead of 4-6 yet still difficult to initially fall asleep. But also seems the positive effects are a bit diminished for my depression + social anxiety compared to earlier on.
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> What augmentations would people suggest? Please try to offer more than one suggestion as some meds are not available in Canada.
>
>Hi AdamCanada2!!!
Well, it seem that we have the same problem....very sensible to side-effects of drugs. I also live in the Canada and here, the choice of drugs are more limited than in the States...I also try the Parnate in November and December 2008...I wrote severals posts here about my experience... At a dose higher than 20mg, it was almost intolerable...a lot of dizness, orthostatic hypotension, strange noisein my ears when I climbing the stairs, lost of vision, change in my vision, increase blood pressure...
Like you, I had a partial reduction on my social phobia...but i'm not sure if it was because my "focus" was more in the side-effects of the Parnate and cause a reduction in my thoughts about the others when I Was in a social situation...
Sometimes I can tolerate high dose if a drug without encounter any intolerable side-effects (Zoloft, Cipralex, Celexa), and sometimes I can't tolerate a drug at all (Parnate, Prozac, Effexor-XR, Wellbutrin-SR or XR, Risperdal, Zyprexa...). I don't know why...but I really think that social anxiety is the most hard disease to treat...
I recommend to you maybe to switch to the Nardil, since I was able to tolerate it at 75mg/day...a normal dosage for almost everyone... I had a partial answer on it as well...I was able to reduce my intake of Rivotril on it at the time...but I up my dosage at 90mg for 2 weeks and I had episodes of orthostatic hypotension that freaking me out, so I just stop the Nardil cold turkey because I Was affraid...but now that I experienced more hard side-effects from the Parnate, i'm ready to give to the Nardil another try...
IF you decide to up your dosage of the Parnate and want something to avoid orthostatic hypotension and dizness like you experience at 20 mg of PArnate, ask your Doctor about a drug call Florinef...it's suppose to help to reduce the hypotension effect of the Parnate...
For the Valium, 5 mg X 2 /day is ok...but it's a low dosage... if you never had addiction to benzo drugs, I suggest to you maybe to switch to the Rivotril, since it have a more long half-life than the Xanax...The Xanax is more for panic attack...Rivotril work more on social anxiety...(In my case I become addicted to it so I had to withdraw it and change for the Valium, i'm now at 20mg/day).
For the insomnia, you can ask for a low dose of Seroquel...but the REGULAR formulation...you take it 30minutes before the bedtime (25mg) and you will fall asleep fast and you will avoid early wake up or insomnia in the middle of the night...since I take this, I sleep 6 hours and more by night...
I think for now, just focus on one drug at the time, and get a dosage you will be able to tolerate will be the main goal to achieve...the addition of an extra drug to the Parnate seem a little bit early as a solution in your case...
One thing is sure, the Nardil have less side-effect...and is more easy to tolerate than the Parnate...who can stimulate you at first but become more and more sedating with time...also avoid to up your dose like I do too fast...it's probably why I had so many side-effects on the Parnate...I wanted to see results in 1 week but it also make the experience very hard to tolerate in my case...
For now, I see my PDoc in 1 1//2 weeks, he put me on the Manerix temporary...I had an extreme intolerance to it....big headache and migraine that never fade away and an increase of anxiety...so I just stop it...We will try me and my PDoc to have some Marplan (another MAOI only avaible in the USA) and try it...but I will ask before to return on the Nardil, since it's cover by insurrance and avaible in the Canada...For now, I only survive with my Valium pills...I double the dose because I Feel nervous...I know it's not good for me do to it because i'm addicted to benzo drugs but I have no choice...
With a good PDoc, i'm sure you will be able to find a solution to your problem...Some people like me need only small dose of a drug to help them...others will need higher dose...I think we are all different...and we react all differently to drugs...
Don't give up ...you are not alone in the same boat!!! ;-)Take care of you and if you want to ask more questions, my babblemail is on!!!
Bye!
Vincent ;-)
poster:Vincent_QC
thread:875655
URL: http://www.dr-bob.org/babble/20090104/msgs/875905.html