Posted by JadeKelly on February 28, 2009, at 16:46:11
In reply to Re: 20mg parnate...is 80mg ok? » JadeKelly, posted by myco on February 28, 2009, at 11:05:53
> Hey Jade,
>
> What dose did you see the insomnia start to really diminish?
> Is the therpeutic dose max (if it is a max?) 30mg? and some of you par-na-teers are on 80?...what I mean is: is it acceptable to go way above 30mg in a dr's eyes? Partnate is in the relatively near future for me I think.
>
> thanks,
> myco
>
>
> > I started at 30mg. Had a nice euphoric 2nd week. Yes, there is insomnia on and off. The higher you go, the less insomnia. Mostly just at dosing time. 25mg seraquel should do it but see what your Doc says. You should treat insomnia aggresively. I've heard that over and over. Its not a free ride on your way out of depression. You just really have to find what works for insomnia. I got a new PDoc and then rapidly titrated to 80mg Parnate and 60mg Ritalin. I no longer have any insomnia.
> >
> > Good Luck!
> >
> > ~Jade
>
>The old therapeutic range for Parnate was 30mg to 60mg. For many PDocs, a higher dose is used, and I believe the new recommended range is 40mg-80mg,
however, PDocs specializing in MAOI's can go much higher. In addition, they should be familiar with augmunting with Stims, and certain tca's. This is something I would NEVER try to do on my own or with an inexperienced PDoc. In answer to your question, paradoxicaly, I think it was around 50mg Parnate that not only did I not have insomnia, my head hit the pillow and I was gone. That was around the time my PDoc added ritalin also. Now, like today I slept in by accident, I didn't take my first dose of 40P and 30R until 11:30am, 2nd dose 4:30pm. I'm expecting I'll be up till 2am unless I intervene. I'm a night person anyway.It is not only expected to go above 30mg Parnate its likely. Maybe your one of the very few that will respond to a small dose. Don't count on it. I wouldn't be on Parnate if I had to stay at 30mg.
Some PDocs are afraid of MAOI's. I looked carefully in my area for a well know PDoc who specialized in MAOI's and the experience to augment with stims or tca's if needed. If your PDoc doesn't have these qualifications, or you are uncomfortable sticking with such a program until remission, I would say this is not the med for you. What concerns me is that insomnia, etc seems to the deciding factor. I was so deeply depressed, I would have put up with just about any side effect to get to remission, if I believed it was waiting if I was patient. And it was. You're going to have s/e's with any a/d. How depressed are you? Parnate is the kind of med that you just have to decide. Am I going to do this or not. You can't keep questioning yourself or you'll go nuts. Why are you taking risperidone?
I would strongly advise waiting for a higher dose, 40-50mg before augmenting.As an aside: Insomnia is such a non-issue for me that I'm tapering off Klonopin and don't even notice. In the last few weeks I've gone from 3mg day to 1.5 mg per day. This was my idea not PDoc's.
Good luck!
~Jade
poster:JadeKelly
thread:882632
URL: http://www.dr-bob.org/babble/20090223/msgs/883099.html