Posted by SLS on May 31, 2012, at 6:29:06
In reply to parnate dose too high?, posted by g_g_g_unit on May 31, 2012, at 4:45:17
> I went up to 50mg of Parnate three days ago and am getting this relatively uncomfortable 'wired' sensation. It feels like excess noradrenergic activity and leaves me feeling kind of numb, blank-minded and interferes with the fluidity of my reading, for example (i.e. my focus becomes very choppy). Taking like 1/6 of a 0.5mg Klonopin tab (hey -- I'm sensitive) resolves the problem, but obviously isn't a long term solution.
>
> I know there's some catch up that occurs between the stimulant and MAO-inhibiting effects, so should I wait it out a bit?
>
> One good sign (per Dr. Gilman's formulation) is that my blood pressure has finally dropped to a noticeable degree, so I thought it might mean I was in fact hitting upon a therapeutic dose.
I think you answered your own questions.It is not unusual for old side effects to reemerge upon dosage increases and for new ones to develop. Hopefully, these will resolve in a week or two.
In the old days, a drop in blood pressure upon orthostatic challenge was used as an index of MAO inhibition. If I recall accurately, doctors looked for a 10% or greater decrease in pressure upon standing from a seated position.
I think it is prudent to give each dosage increase a period of three weeks before evaluating its effectiveness and making further adjustments.
I hope that you are getting closer and closer to a robust response to your treatment.
Good luck.
- 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:1018986
URL: http://www.dr-bob.org/babble/20120522/msgs/1018987.html