Posted by SLS on February 5, 2012, at 6:35:18
In reply to starting Parnate tomorrow, posted by g_g_g_unit on February 4, 2012, at 22:03:45
> So my psychiatrist and I decided to go with Parnate in the end. I'll be starting at 20mg tomorrow, before moving up to 30mg after a week. He consulted Stahl's prescribing manual and is willing to go up to at least 60mg.
Good plan.
> I asked if he would prescribe clonidine for insomnia,
Clonidine can produce depression in people who have no mental illness. I would be wary of this if you should go ahead with it.
The low-dose (25-100 mg) Seroquel is a valid alternative for treating insomnia. There is even a chance that it will make the Parnate work better. The major metabolite of Seroquel (norquetiapine) inhibits the reuptake of norepinephrine (NE). I haven't investigated this well enough to know what dosages of Seroquel are necessary for this mechanism to have the best clinical effect. However, I have seen the addition of Seroquel produce a dramatic antidepressant effect in a young woman at 50 mg. She was taking Risperdal at the time.
DO NOT give up on Parnate just because insomnia becomes a problem. You might have to treat the insomnia with the save aggressiveness with which you are treating the depression.
Trazodone is a yucky drug. It almost always produces a hangover effect the next day. It does work, though.
Can you list the specific drugs you have tried to treat insomnia and what were the results?
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1009314
URL: http://www.dr-bob.org/babble/20120202/msgs/1009343.html