![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 36. This is the beginning of the thread.
Posted by ed_uk on February 20, 2005, at 12:10:18
I know you've only just started it but I wondered how you were doing.
Ed.
Posted by Optimist on February 22, 2005, at 17:10:04
In reply to Optimist, how are you doing on Parnate?, posted by ed_uk on February 20, 2005, at 12:10:18
Hi Ed, thanks for inquiring.
I had a pretty good first week on Parnate. I started with 20mg day 1, 40mg days 2-4, then 60mg days 5-7. I felt more sociable, friendly, bold/confident, and energetic almost immediately. Not sure if it was the placebo effect working or the initial stimulant nature of the drug. I also felt a need/compulsion to increase my dose which was odd for me. I've felt that a little perhaps when I was on Wellbutrin, Prozac, and Adderall but not nearly as close. Is it addiction qualities or does it happen to be exactly what my body needs? Time will tell...
I was actually doing quite well until yesterday. I started noticing some sexual side effects yesterday for the first time... mainly problems with erection quality and difficulty keeping it that way. My mood seems to have dipped starting yesterday as well which I'm sorta puzzled about. I've also noticed a marked agitation which is bothering me. I'm theorizing it may be due to the 5HT2a effects at the higher doses. Still no insomnia, or hypotension what so ever which is comforting. The diet is a joke.
I realized today that my first week on an antidepressant I usually have a particularily robust response then it seems to taper off. I'm not sure if it's a placebo effect, some kind of bipolar variation, or the initial stimulation caused by a new drug, particularily the one's I've taken in the past which are all activating. Prozac, Wellbutrin, and Lamictial were like that, whereas Effexor was not, so I'm not sure where my theory is going at the moment.
I'm kind of wondering if it was a smart move on my part to increase the dosage so quickly. It's hard to say at this point. I'm getting kinda impatient regarding wanting to get better, and wanting to get on with my life. I am most definitely going to stick with Parnate for awhile though. If I don't get the desired responce I'm looking for I'll most likely augment it with Lithium, and/or something to increase dopamine, like a DA agonist or 5-HT2a blocker. A 5-HT2a blocker may be the best route since I have an impression that it tends to have less of a poopout rate than the more direct dopaminergic drugs i.e. amphetamines, agonists, etc... Possiblities include Trazodone, or low dose AP's, or the best option may be just increasing the Parnate until it acts as a 5-HT2a antagonist which happens once you get over 100-120mg or so I believe. Serzone, and Amilsulpride are out of the question since they aren't approved in Canada. So far, the prodopamine effects aren't as robust as the dopamine agonist herb, Vitex I was on before.
Anyways, I'm getting ahead of myself. I've only been on the drug one week and I'm already thinking of augmentation. :) I'll see what my pdoc says in a week for my follow up. I think she would have prefered me to increase my dose more slowly. I don't want to be labelled non-compliant, but she's seems to be pretty understanding of those things.
I'll keep you updated again in a weeks time. Thanks for the encouragement. :)
Brian
Posted by ed_uk on February 23, 2005, at 7:36:38
In reply to Re: Optimist, how are you doing on Parnate? » ed_uk, posted by Optimist on February 22, 2005, at 17:10:04
Hi Brian!
> I started with 20mg day 1, 40mg days 2-4, then 60mg days 5-7.
>I started noticing some sexual side effects yesterday for the first time... mainly problems with erection quality and difficulty keeping it that way.
>I've also noticed a marked agitation which is bothering me.Wow, that's a fast increase in dose. With MAOIs, side effects often seem to take a few weeks to develop at any given dose. You might actually feel better on a lower dose :-)
>My mood seems to have dipped starting yesterday as well which I'm sorta puzzled about.
Other people have reported this, I expect the Parnate will 'kick in' in a few weeks time. If I were you, I'd definitely consider reducing the dose though- for example to 30mg a day. After taking 30mg for a few weeks you could increase the dose if necessary- which it might not be. It might be best to wait several weeks between dose increases. If you increase the dose rapidly, you're likely to end up on an excessive dose which may cause too many side effects and make you feel worse. I know how hard it is to be patient, I saw my new doctor on Monday and the only drug he was willing to prescribe was Effexor- even though I've tried it before and didn't like it. Stimulants and MAOIs are clearly out of the question. He told me that Effexor was the only option. I told him that I didn't want to take Effexor, he responded by saying that he will only see me a couple of times a year.
>I'll keep you updated again in a weeks time. Thanks for the encouragement. :)
You're welcome, please post soon.
Posted by up'n'down on February 24, 2005, at 1:12:29
In reply to Re: Optimist, how are you doing on Parnate? » Optimist, posted by ed_uk on February 23, 2005, at 7:36:38
I'm very sorry to hear about a psy. doctor who limits so severely what he/she will give re: meds. Since all of us are so different, there is no one med that fits all sizes. Please don't be dismayed-is it possible to work with another professional in the same office, or is the dr. going to try other kinds of therapy with which you agree? Tell us more. U'D
Posted by ed_uk on February 24, 2005, at 9:53:28
In reply to To ed-uk, posted by up'n'down on February 24, 2005, at 1:12:29
Hi :-)
>Please don't be dismayed-is it possible to work with another professional in the same office, or is the dr. going to try other kinds of therapy with which you agree?
The pdoc I saw on Monday was my new pdoc. He agreed to see me again in 6 weeks but won't see me regularly after that. I want to find a doctor who will treat me for chronic fatigue and hypersomnia. None of the pdocs that I've seen have ever taken my fatigue seriously. When I tell tham I'm not depressed they just aren't interested. Most pdocs in the UK seem to think that Effexor is the answer to everyone's problems. I'd like to try Provigil but it's very rarely prescribed here- my last pdoc hadn't even heard of it. My new pdoc refered my to a psychologist but the waiting list is 8 months and I'd only get about 10 sessions at the most.
Best Regards,
Ed.
Posted by Optimist on February 24, 2005, at 11:34:22
In reply to Re: To ed-uk » up'n'down, posted by ed_uk on February 24, 2005, at 9:53:28
> Hi :-)
>
> >Please don't be dismayed-is it possible to work with another professional in the same office, or is the dr. going to try other kinds of therapy with which you agree?
>
> The pdoc I saw on Monday was my new pdoc. He agreed to see me again in 6 weeks but won't see me regularly after that. I want to find a doctor who will treat me for chronic fatigue and hypersomnia. None of the pdocs that I've seen have ever taken my fatigue seriously. When I tell tham I'm not depressed they just aren't interested. Most pdocs in the UK seem to think that Effexor is the answer to everyone's problems. I'd like to try Provigil but it's very rarely prescribed here- my last pdoc hadn't even heard of it. My new pdoc refered my to a psychologist but the waiting list is 8 months and I'd only get about 10 sessions at the most.
>
> Best Regards,
> Ed.Hi Ed... I didn't think I had problems with depression for the longest time. I thought I just had problems with energy, motivation, confidence, which would go away once I ate better, or got some underlying medical problem solved. As the years went by I think my depression slowly crept up on me. Perhaps that's the difference between atypical and melancholic depression... especially a mild form of atypical=dysthymia which may be more subtle. MAOI's are supposed to be the best AD's for atypical depression as I'm sure you've heard.
I'm sure you will find a sympathetic doctor soon if you keep plugging away. Keep it up!
Brian
Posted by ed_uk on February 24, 2005, at 11:58:26
In reply to Re: To ed-uk, posted by Optimist on February 24, 2005, at 11:34:22
Hi Brian,
How are your side effects? Are you still taking 60mg?
>I'm sure you will find a sympathetic doctor soon if you keep plugging away.
Thanks :-) I don't know how to find one though. I can't ask my new pdoc to refer me to another pdoc because he'd just say no, anyway he'd be offended.
Ed.
Posted by Optimist on February 24, 2005, at 23:37:32
In reply to Re: Parnate » Optimist, posted by ed_uk on February 24, 2005, at 11:58:26
> Hi Brian,
>
> How are your side effects? Are you still taking 60mg?
>
> >I'm sure you will find a sympathetic doctor soon if you keep plugging away.
>
> Thanks :-) I don't know how to find one though. I can't ask my new pdoc to refer me to another pdoc because he'd just say no, anyway he'd be offended.
>
> Ed.My side effects aren't too bad now. The agitation seems less noticable now, almost non-existant, and the sexual dysfunction is pretty minor. No delayed ejaculation, just a little problem with erectile quality but not that bad. Just not 100%, which I'm not expecting right now anyways. :)
Yeah, I'm still takign 60mg a day, 20 for breakfast, lunch, and dinner. Zero insomnia still, sleeping like a baby. I'm not going to lower it at the moment. I almost would prefer to go above 100mg as soon as possible if anything since it starts acting as a 5HT2a antagonist around that point, which means less agitation, sexual dysfunction, and more dopamine which I think I could use a little more of. I think I heard it reduces dopamine in the long run at more moderate doses 50-100mg, due to 5HT2a stimulation ,but I'm not completely certain.
I think I am getting better though. Perhaps mon and tues were just a blip. It's weird... Parnate is acting so subtle, it's so much more of a natural feeling. It's lifting the depression without the speediness, apathy, and bad side effects of other drugs. It's like it's hitting the exact deficiency that made me depressed in the first place. I'm sure that's not true but it sure feels like it anyways. Like the wonder and excitement of a child is returning.
I may ask my pdoc for a low dose lithium augmentation next week. I know I do have cycles to my depressions, with summers and winters being much worse. Lithium is supposed to help with hypoglycemia as well which MAOI's exacerbate. Hypoglycemia is something I've been battling for awhile, but is getting much better with the addition of high dose niacinamide, chromium, and licorice.
Are there any resources you can check regarding pdocs? How about teaching hospitals, universities, etc... If I was in your case I think I would just order the stuff my self. It's not the best option, but neither is the next 20 years of Effexor/SSRI's if they don't work for you either.
Brian
Posted by ed_uk on February 26, 2005, at 10:40:28
In reply to Re: Parnate » ed_uk, posted by Optimist on February 24, 2005, at 23:37:32
Hi Brian!
Hey, it sounds like you're doing well :-)
>I almost would prefer to go above 100mg as soon as possible if anything since it starts acting as a 5HT2a antagonist around that point
Where have you read this? I honestly wouldn't recommend increasing the dose until you've been on 60mg long enough to find out how it's going to affect you.
>Like the wonder and excitement of a child is returning.
I want to try Parnate!
>I may ask my pdoc for a low dose lithium augmentation next week.
Brian! You probably won't need lithium once you've been on Parnate for a few weeks.
>If I was in your case I think I would just order the stuff my self.
I'm thinking of it!
Ed.
Posted by willyee on February 26, 2005, at 23:30:50
In reply to Re: Parnate » Optimist, posted by ed_uk on February 26, 2005, at 10:40:28
> Hi Brian!
>
> Hey, it sounds like you're doing well :-)
>
> >I almost would prefer to go above 100mg as soon as possible if anything since it starts acting as a 5HT2a antagonist around that point
>
> Where have you read this? I honestly wouldn't recommend increasing the dose until you've been on 60mg long enough to find out how it's going to affect you.
>
> >Like the wonder and excitement of a child is returning.
>
> I want to try Parnate!
>
> >I may ask my pdoc for a low dose lithium augmentation next week.
>
> Brian! You probably won't need lithium once you've been on Parnate for a few weeks.
>
> >If I was in your case I think I would just order the stuff my self.
>
> I'm thinking of it!
>
> Ed.
>Nothing more than my two cents of being on it over four years......milk it at the lowest effect dosage.......and milk it with as little augemntation as possable.
I had a response the first 48 hrs,and the first year feared the Maoi properties more so i did not take many augmentors,or mess with the dose.
When i did.....well to this day i cant regain the specific AD effect i initially had.Enjoy it while its there and easy.
LOL Once you begin augmenitng,and messing with the dose,theres no turning back!Good luck
Posted by Optimist on February 27, 2005, at 10:27:14
In reply to Re: Parnate, posted by willyee on February 26, 2005, at 23:30:50
> > Hi Brian!
> >
> > Hey, it sounds like you're doing well :-)
> >
> > >I almost would prefer to go above 100mg as soon as possible if anything since it starts acting as a 5HT2a antagonist around that point
> >
> > Where have you read this? I honestly wouldn't recommend increasing the dose until you've been on 60mg long enough to find out how it's going to affect you.
> >
> > >Like the wonder and excitement of a child is returning.
> >
> > I want to try Parnate!
> >
> > >I may ask my pdoc for a low dose lithium augmentation next week.
> >
> > Brian! You probably won't need lithium once you've been on Parnate for a few weeks.
> >
> > >If I was in your case I think I would just order the stuff my self.
> >
> > I'm thinking of it!
> >
> > Ed.
> >
>
> Nothing more than my two cents of being on it over four years......milk it at the lowest effect dosage.......and milk it with as little augemntation as possable.
>
> I had a response the first 48 hrs,and the first year feared the Maoi properties more so i did not take many augmentors,or mess with the dose.
>
> When i did.....well to this day i cant regain the specific AD effect i initially had.Enjoy it while its there and easy.
>
> LOL Once you begin augmenitng,and messing with the dose,theres no turning back!Good luck
>
>
Willyee,How high did you go and what augmentors did you use?
Brian
Posted by Optimist on February 27, 2005, at 11:40:49
In reply to Re: Parnate » Optimist, posted by ed_uk on February 26, 2005, at 10:40:28
> Where have you read this? I honestly wouldn't recommend increasing the dose until you've been on 60mg long enough to find out how it's going to affect you.
I can't remember the exact sources... mostly from doing searches here and on google. I think Jay Amsterdam MD, says something about it specifically. He supposedly routinely uses high dose Parnate(up to 330mg) with TRD patients. I know Chairman_MAO mentioned the high dose change in pharmacodynamics a couple times here.
The lithium isn't so much to increase the effectiveness of Parnate as it is to prevent poopout... more as a prophylactic. My grandmother was Bipolar 1, and had a tragic ending after she went off her lithium 30 years ago. My sister may most possibly be bipolar 1 as well. She hasn't been diagnosed as so... so far she's been diagnosed with some schizoaffective disorder. When she's psychotic though she hardly sleeps at all, and has felt suicidal at other times. She's currently taking 60mg Celexa, and 15mg Zyprexa. Lastly my father has had major depression for the last 20 years. He's hinted at having hypomania at times, but the depression is there probably 99% of the time. He's on Amitryptaline, and Divalproex(Epival), partly for depression and partly for chronic migraine prophylaxis.
I've wrestled with the idea that I may have some bipolar variant for a number of years now, probably cyclothymia or a form that goes from dysthymia to normal. I've been called a Dr. Jeckle and Mr. Hyde by my current girlfriend. :)
> >If I was in your case I think I would just order the stuff my self.
>
> I'm thinking of it!Whatever you do make sure you have the necessary failsafes to keep you on track. Arming yourself with a lot of knowledge can only make things better. You seem well on your way to achieving that though. :)
Brian
Posted by ed_uk on February 27, 2005, at 12:02:55
In reply to Re: Parnate » ed_uk, posted by Optimist on February 27, 2005, at 11:40:49
Hi Brian!
>The lithium isn't so much to increase the effectiveness of Parnate as it is to prevent poopout... more as a prophylactic.
If you do decide to add lithium, I'd definitely suggest a very low dose eg. plasma conc 0.3-0.4. High doses are more useful as a treatment for mania and tend to be unpleasant.
>My sister may most possibly be bipolar 1 as well. She hasn't been diagnosed as so... so far she's been diagnosed with some schizoaffective disorder.
Probably schizoaffective disorder, bipolar sub-type.
>I've been called a Dr. Jeckle and Mr. Hyde by my current girlfriend. :)
Why does she call you that? I bet you aren't as irritable as me!
Good luck,
Ed.
Posted by Optimist on February 27, 2005, at 15:59:47
In reply to Re: Parnate » Optimist, posted by ed_uk on February 27, 2005, at 12:02:55
> If you do decide to add lithium, I'd definitely suggest a very low dose eg. plasma conc 0.3-0.4. High doses are more useful as a treatment for mania and tend to be unpleasant.
That's what I would be aiming for... I've never had severe mood swings, so a lower dose would probably suit fine. The only thing I'd really worry about at lower doses would be acne since I am predisposed to it, although I have it under control at the moment for the first time in my life. :) I'm wondering if any of the supplements/drugs I'm on are helping in that regard. The last few months I've had good skin.
> Probably schizoaffective disorder, bipolar sub-type.
Yeah probably, she was prescribed lithium in the summer during an especially psychotic period. She did not want to take it though since she was pregnant at the time. The biggest reason she wouldn't taken it is probably due to it's negative connotation with it's use in bipolar. It sounds a lot worse than what it really is. Personally I think Zyprexa is a much harsher drug.
>
> >I've been called a Dr. Jeckle and Mr. Hyde by my current girlfriend. :)
>
> Why does she call you that? I bet you aren't as irritable as me!My personality can be very flat, quiet, and introverted during my depressive phases. I also tend to have more mood reactivity especially when I have some caffeine in me then. Other times when I'm feeling better I can be much more charasmatic, exciting, sexual, social, etc... so I bet it can be confusing for her at times. She has said that I would be a different person everytime she saw me. Perhaps that's how well the depression was fighting through at that particular time, or the mood reactivity associated with atypical depression. I find it hard to self evaluate sometimes. Whatever may seem normal to me, may seem moody to others so who knows.
My pdoc doesn't think I have any form of bipolar though since I don't have much variation in sleeping from when I'm depressed to when I'm feeling better. I can never feel rested after 3 hours sleep, not even after 5 or 6 during either period. I usually require between 8 and 10 hours depending on the day.
Brian
Posted by ed_uk on February 27, 2005, at 16:19:05
In reply to Re: Parnate » ed_uk, posted by Optimist on February 27, 2005, at 15:59:47
Hi Brian!
I also used to have acne. I took Roaccutane (Accutane) and it went away.
>Other times when I'm feeling better I can be much more charasmatic, exciting, sexual, social, etc...
You sound nice :-) It would be fun to meet you and the other people on p-babble.
Ed.
Posted by Optimist on February 27, 2005, at 22:52:57
In reply to Re: Parnate » Optimist, posted by ed_uk on February 27, 2005, at 16:19:05
Hey Ed,
> I also used to have acne. I took Roaccutane (Accutane) and it went away.
Yeah I've been on it twice myself. The first time exactly coincided with the start of my first depression at age 17. How about you, any similarities between the two? I found Accutane didn't really help that much long term, short term yes. I took 90mg per day the first time and experienced bad depression, then the second time it was 40mg or something around there I think and now that I recall I think I was much more tired than usual then. Since depression runs in my family the accutane may have brought the susceptability out. It's possible...
> You sound nice :-) It would be fun to meet you and the other people on p-babble.
I was thinking the same thing. There's many interesting and intelligent people on these boards, although a reunion most likely wouldn't be practical. I find myself looking for certain people's posts when I log on here. Usually people with similar problems and/or drugs, as well as the more astute fellows here. I often find myself thinking of ideas to help others on this board when I'm doing other things. I find it rewarding to help someone who may be suffering. It may be only one or two distinctions that can make all the difference in one's life. :)
All the best,
Brian
Posted by ed_uk on February 28, 2005, at 7:59:48
In reply to Re: Parnate » ed_uk, posted by Optimist on February 27, 2005, at 22:52:57
Hi Brian :-)
>The first time exactly coincided with the start of my first depression at age 17. How about you, any similarities between the two?
I'm not sure really. Soon after I took it I started sleeping all day and dropped out of school. I don't know if there's any link though.
>I took 90mg per day the first time and experienced bad depression, then the second time it was 40mg or something around there I think and now that I recall I think I was much more tired than usual then.
I took 70mg for 3-4 months.
>There's many interesting and intelligent people on these boards, although a reunion most likely wouldn't be practical.
No... it wouldn't, we all live too far away! Must go to bed now, still recovering from a virus :-(
All the best,
Ed.
Posted by Optimist on February 28, 2005, at 11:52:09
In reply to Re: Parnate » Optimist, posted by ed_uk on February 28, 2005, at 7:59:48
Hey Ed,
> I'm not sure really. Soon after I took it I started sleeping all day and dropped out of school. I don't know if there's any link though.It's possible Accutane may have had a hand in your fatigue. What's done is done though, so it's better to look towards solutions at this point.
> I took 70mg for 3-4 months.
Both my cycles were for 4 months.
> No... it wouldn't, we all live too far away! Must go to bed now, still recovering from a virus :-(
Hope you're feeling better shortly, :)
Brian
Posted by ed_uk on March 2, 2005, at 6:35:44
In reply to Re: Parnate » ed_uk, posted by Optimist on February 28, 2005, at 11:52:09
Hi Brian!
How are you doing on Parnate? Any change? I know it's only early days!
Ed.
Posted by Optimist on March 2, 2005, at 20:28:26
In reply to Re: Parnate, posted by ed_uk on March 2, 2005, at 6:35:44
> Hi Brian!
>
> How are you doing on Parnate? Any change? I know it's only early days!
>
> Ed.Hi Ed,
Thanks for checking in. :)
I would say things are getting better day by day. One thing I have to say is I'm pretty surprised with some people's intolerance of side effects with Parnate. It seems like such a mild drug to me, in terms of side effects that is, not antidepressant efficacy. I don't discount any one's experience with this drug though. I tend to not have many side effects with drugs anyways.
I'm sure you may be shocked but I'm taking 100mg per day now and aren't really experiencing anything negative. Still some mild sexual dysfunction but nothing too major. Less than 20mg of Prozac for sure. I've also heard that it's supposed to go away for the most part on Parnate. With Prozac I'm not as sure.
At 100mg I've noticed much more stimulation, a pleasant mild euphoria I guess the right word would be. Some caffeine contributes significantly to this effect and they seem to work synergistically together. I've noticed I'm becoming more friendly and outgoing as well... more apt to strike up conversations with people. I'm sure this will only get better with time. The prosocial effects of Nardil seem to not kick in till a month for most people. I wonder if Parnate is similar in that regard?
Still no problems with sleeping, hypotension, or mid-day tiredness. I have noticed my mouth is significantly more dry than usual. This seemed to kick in around 60mg, but it's not too big a deal. I drink a lot of water normally anyways.
I think my little blip last mon and tues may have been due to adding some responsibilities to my life and the stress that ensued. I've started looking for a new job to try and find something better than where I currently am, and felt a little guilty for not getting anything done on my days off last week. I do feel that I am looking more to the future though, and planning goals for my life. I find when I'm depressed that is very hard to do. Any concept of future plans and goals at that time felt anxiety provoking to me. Some of my depression ties in to existential analysis I believe. It has been on my mind for the last 10 years or so, what I want to do with my life, and being dysthymic throughout that period made goalsetting very difficult. Actually I made lots of goals but could never stick to them. The bottom always seemed to fall out, or I would become unsure of myself and bail. It's most likely part biological susceptibility, and part perception of life events. I do think there is a strong biological component to it though. It's hard to tease the two apart and figure out what is causing the problem at any particular time.
I'm most likely going to ride out the 100mg for awhile now. I think the peak of MAO inhibition is around 80mg, and it's starting to get expensive at this dosage as well, around $150 CN... all out of pocket. I need to get some insurance! With that and all the supplements I buy it can get pretty expensive. I take a lot of vitamins and minerals, etc... I'm a strong believer that you have to have all the necessary enzymes, and chemical reactions operating properly in order for a medication to work properly.
Hope all is well,
Brian
Posted by willyee on March 2, 2005, at 21:40:52
In reply to Re: Parnate: 2 week progress report » ed_uk, posted by Optimist on March 2, 2005, at 20:28:26
Hey i too found caffiene at times to go really well with parnate....however it is a contradiction and i was the only one who seemed to do it.....i kinda cut back,it at least makes me feel better to know im not crazy and they can go well togther.
If you dont mind i have two questions id really like to know....how do you dose,as far as increments,this i have trouble with,for example 20 mg dose...30mg dose....etc.The most im able to tolerate at a setting is 40 mg at a single time,im very curious to know your routine.
ALso are you speaking of caffeine in pure pill form like viavrin,this is where i see notable effects,not from average caffiene intake through a soda.
Posted by Optimist on March 3, 2005, at 19:15:53
In reply to Re: Parnate: 2 week progress report, posted by willyee on March 2, 2005, at 21:40:52
> Hey i too found caffiene at times to go really well with parnate....however it is a contradiction and i was the only one who seemed to do it.....i kinda cut back,it at least makes me feel better to know im not crazy and they can go well togther.
Caffeine doesn't seem to effect my blood pressure much. I can take 400mg at a time and it doesn't seem to do much. The antidepressant qualities and energy though are substantial.
> If you dont mind i have two questions id really like to know....how do you dose,as far as increments,this i have trouble with,for example 20 mg dose...30mg dose....etc.The most im able to tolerate at a setting is 40 mg at a single time,im very curious to know your routine.
My increment dosing went:
Day 1: 20mg (10 at lunch, 10 at dinner)
Day 2 - 5: 40mg (20 breakfast, 20 lunch)
Day 6 - 14: 60mg (20 breakfast, 20 lunch, 20 dinner)
Day 15: 80mg (30 breakfast, 30 lunch, 20 dinner)
Day 16 - 18: 100mg (40 breakfast, 30 lunch, 30 dinner)Hope that helps a bit. I know some people can't take the Parnate that late in the day due to insomnia issues but it hasn't really effected me yet so I'm sticking to this schedule.
Do you mean you can only take 40mg at one time or in total in one day? What kind of problems are you having? Overstimulation, agitation, etc...?
> ALso are you speaking of caffeine in pure pill form like viavrin,this is where i see notable effects,not from average caffiene intake through a soda.
Yes, 200mg caffeine pills. I tend to not be a morning person so they really seem to help me get going especially if I have to get up at 6am for work! I drink coffee the odd time but it tends to mess up my blood sugar(hypoglycemia) so I usually reserve it for a treat.
Brian
Posted by willyee on March 3, 2005, at 22:27:44
In reply to Re: Parnate: 2 week progress report » willyee, posted by Optimist on March 3, 2005, at 19:15:53
> > Hey i too found caffiene at times to go really well with parnate....however it is a contradiction and i was the only one who seemed to do it.....i kinda cut back,it at least makes me feel better to know im not crazy and they can go well togther.
>
> Caffeine doesn't seem to effect my blood pressure much. I can take 400mg at a time and it doesn't seem to do much. The antidepressant qualities and energy though are substantial.
>
> > If you dont mind i have two questions id really like to know....how do you dose,as far as increments,this i have trouble with,for example 20 mg dose...30mg dose....etc.The most im able to tolerate at a setting is 40 mg at a single time,im very curious to know your routine.
>
> My increment dosing went:
>
> Day 1: 20mg (10 at lunch, 10 at dinner)
> Day 2 - 5: 40mg (20 breakfast, 20 lunch)
> Day 6 - 14: 60mg (20 breakfast, 20 lunch, 20 dinner)
> Day 15: 80mg (30 breakfast, 30 lunch, 20 dinner)
> Day 16 - 18: 100mg (40 breakfast, 30 lunch, 30 dinner)
>
> Hope that helps a bit. I know some people can't take the Parnate that late in the day due to insomnia issues but it hasn't really effected me yet so I'm sticking to this schedule.
>
> Do you mean you can only take 40mg at one time or in total in one day? What kind of problems are you having? Overstimulation, agitation, etc...?
>
> > ALso are you speaking of caffeine in pure pill form like viavrin,this is where i see notable effects,not from average caffiene intake through a soda.
>
> Yes, 200mg caffeine pills. I tend to not be a morning person so they really seem to help me get going especially if I have to get up at 6am for work! I drink coffee the odd time but it tends to mess up my blood sugar(hypoglycemia) so I usually reserve it for a treat.
>
> Brian
You answered my question perfectly actualy.As far as daily intake most times its not accumative
so i can take who knows in a daily setting.I was reffering to a single dose,40 is the max and usualy only done if im really getting nothing from it.....lots of times a 30 mg dose or a 20 mg dose is fine.....a 10 mg dose makes me worse unless it is a miantenance dose following a larger dose a few hours later.Thanks again.
Posted by Optimist on March 3, 2005, at 22:47:38
In reply to Re: Parnate: 2 week progress report, posted by willyee on March 3, 2005, at 22:27:44
> You answered my question perfectly actualy.As far as daily intake most times its not accumative
> so i can take who knows in a daily setting.
>
> I was reffering to a single dose,40 is the max and usualy only done if im really getting nothing from it.....lots of times a 30 mg dose or a 20 mg dose is fine.....a 10 mg dose makes me worse unless it is a miantenance dose following a larger dose a few hours later.Thanks again.I'm a little confused. Do you take 40mg everyday or does your dose depend on how you're feeling?
Brian
Posted by willyee on March 3, 2005, at 23:35:08
In reply to Re: Parnate: 2 week progress report » willyee, posted by Optimist on March 3, 2005, at 22:47:38
I take 70 mg daily.....i try to take less whenever possable.But yess if i have a therputic response i will take 20 mg,if otherwise i over amp myself.
I know this sounds wierd,but i have been on it close to 5 years,and im very familiar with its onset.I did take it at a consistent dose and time my first year or two,but i find it more effective if listen to how im feeling.
This of course is not somethig id advise anyone to do,especialy a person just on it.One example is if i am not having any response,ill begin to take 40 mg doses,in a day or two usualy ill achieve a therputic response,if i stay at this high dosage it will turn to depression and make me tired,so when i hit the range for me it is best to begin to lower it back,again this is only after very exstensive self montering of my reaction to dosages,which i achieved through years of familiarility with the med.
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