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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Girlnterrupted78 on August 26, 2009, at 18:24:18
I've been on Parnate for 2 weeks, and I already notice some (mild) antidepressant effects. I went from 10mg, adding 10mg every 3-4 days, up to 40mg and have been on 40mg for about a week now.
The antidepressant effects, although mild, were almost immediate. I didn't have to wait 3 weeks. I definitely feel that I ruminate a lot less, I'm not beating myself up over everything to the point of paralysis, and I feel more clear minded. I can communicate my ideas better and my self-esteem, while still low, has definitely improved. So has my confidence. And my chronic feelings of guilt and shamed have somewhat diminished.
I saw my pdoc today and he told me to stay on 40mgs for a few more weeks because I hadn't reached Parnate's "full effect" yet. I thought we were going to go up to 60mgs or more, because even though my depression is somewhat improved, my social anxiety hasn't been touched.
However, I'm somewhat skeptical that there will be any further effects if I stay on 40mgs longer. From previous experience, the initial antidepressant effect I feel will be all I will ever reach on any specific antidepressant. It has never gone in phases, e.g., from feeling ok, to feeling good, to feeling great. It's usually a one shot deal. So I'm doubtful that staying on 40mgs longer will make a big difference in a few weeks.
Does anyone have experience on this? Will 40mgs of Parnate will be different in 3-4 weeks, even if I already feel antidepressant effects? What about going up to 60mgs or more? Will that make a significant difference? I remember feeling the exact same way on both doses of Celexa: 40mgs & 80mgs, and both doses of Nardil: 60mgs & 90mgs, nothing really changed with the higher doses in terms of antidepressant effects, the only thing that happened was the side effects got worse, so I'm assuming this is pretty much all I'm getting from Parnate based on what happened with previous/similar meds.
I still have the hope that Parnate might do something for my social anxiety, but experience tells me this might not be the case.
If anyone has any insight into this, any comments and info would be greatly appreciated.
Thanks
Posted by floatingbridge on August 27, 2009, at 14:25:20
In reply to How long for Parnate to reach full effect?, posted by Girlnterrupted78 on August 26, 2009, at 18:24:18
Hi Girlinterupted--
Gayle (Coloradosnowflake) would have something to say about your question. It took a while for her's to kick in, but it did.
Good Luck!
fb
Posted by Girlnterrupted78 on August 28, 2009, at 2:44:35
In reply to Re: How long for Parnate to reach full effect? » Girlnterrupted78, posted by floatingbridge on August 27, 2009, at 14:25:20
Well, thank you, floatingbridge, for that referral. Let's see if she wants to come and share her story. It might be slightly different because you say Parnate took a while for her to "kick in". In my case, I think I already have several antidepressant benefits from Parnate, but who knows.. the more I learn about how it works for others, the better.
Let's see if we can get her over here..
Thanks again.
> Hi Girlinterupted--
>
> Gayle (Coloradosnowflake) would have something to say about your question. It took a while for her's to kick in, but it did.
>
> Good Luck!
>
> fb
Posted by ColoradoSnowflake on August 28, 2009, at 14:46:14
In reply to Re: How long for Parnate::Coloradosnowflake req'd, posted by Girlnterrupted78 on August 28, 2009, at 2:44:35
Hi:
The custody trial is OVER! and turned out extremely well!! So now I can breathe again. I will have my little 2 1/2 year old grandson a whole lot more so I'm going to have to be in the very best possible shape!! I am SO relieved and thankful!!
Parnate: Yes, my experience was very different. But I do believe it takes a long time for it to settle in. My pdoc made me promise I would stick with it for 6 months. I was prepared to do that so I'm very happy it is working "so soon". I've been on it since May 4th.
I had quite a few side effects for a while, hypotension, dizziness, spacey feeling, very low blood pressure, very bad fatigue, dry mouth, and more. All are GONE except dry mouth.I think you have to be a lot more patient! I would see what the 40mg does for a while. I was on 50mg, got depressed about the trial and put myself up to 60mg, now I think I'll go back down to 50mg.....will ask my pdoc.
Look at what I wrote this morning to Fred, and let me know any more questions you have. I'd be happy to share anything I know.
You have probably gathered that I take Parnate with TCA nortript which I think is the BOMB. Young pdocs have no experience with it and are afraid of it. Scott posted some good info if your doc needs convincing. My pdoc thinks it makes it smoother, better and SAFER!!
Good luck
Gayle
Posted by SLS on August 28, 2009, at 14:52:03
In reply to Re: How long for Parnate::Coloradosnowflake req'd, posted by ColoradoSnowflake on August 28, 2009, at 14:46:14
> The custody trial is OVER! and turned out extremely well!!
Woohoo!
I wish you continued success with your treatment, and many special moments with your grandson.
Have a nice day.
:-)
- Scott
Posted by ColoradoSnowflake on August 28, 2009, at 21:58:19
In reply to Re: How long for Parnate::Coloradosnowflake req'd » ColoradoSnowflake, posted by SLS on August 28, 2009, at 14:52:03
Thank you so much for those words Scott!!
You are such a kind person!! You help so many of us so much!!
You're The BEST!!
Now it's your turn to get that full remission!!
Gayle
Posted by Girlnterrupted78 on August 28, 2009, at 23:58:36
In reply to Re: How long for Parnate::Coloradosnowflake req'd, posted by ColoradoSnowflake on August 28, 2009, at 14:46:14
Hi Gayle,Thanks a lot for the info you posted, and glad to hear things turned out well at the custody trial. Congrats to you :-)
> I had quite a few side effects for a while, hypotension, dizziness, spacey feeling, very low blood pressure, very bad fatigue, dry mouth, and more. All are GONE except dry mouth.
I have the same side-effects, except for dry mouth. Hypotension and fatigue are the worst ones right now. How long did it take for those side effects to go away? Do you think dosing times would make a difference? (I take 20mgs at 8am and 20mgs at 1pm) I'd like to switch to evening doses to see if I can gather the energy to do some exercise during the day, but I don't know if that would work.
> Look at what I wrote this morning to Fred, and let me know any more questions you have. I'd be happy to share anything I know.Thanks, I actually looked around but couldn't find what you wrote to Fred. What thread was that? Sorry!
> You have probably gathered that I take Parnate with TCA nortript which I think is the BOMB. Young pdocs have no experience with it and are afraid of it.Yes, I did notice several people here are on that combo. The doctor I'm seeing now is a research specialist and when I mentioned the Nortript to him he didn't seem to think it was that great of an idea. He is all set on augmenting with Abilify (which I hated when they used to augment my SSRI + gave me awful side effects.) Do you think Nortriptyline would be a better augmentor than Abilify? I might try to convince my doc it it's worked for others so well.
So tell me one thing: Parnate didn't start working for you until you augmented with Nortryp? Or did it just get "better" once it was augmented?
Thanks a lot for your help!
GI
Posted by Girlnterrupted78 on August 29, 2009, at 0:02:37
In reply to Re: How long for Parnate::Coloradosnowflake req'd, posted by ColoradoSnowflake on August 28, 2009, at 14:46:14
Hey Gayle, I forgot to ask you one question:
Do you have social anxiety? Just wanted to know if you do, and if so, did the Parnate resolve that? That's almost my main reason for taking it, so I'm trying to figure this out.
Thanks again.
Posted by ColoradoSnowflake on August 29, 2009, at 0:50:12
In reply to Re: How long for Parnate::Coloradosnowflake req'd » ColoradoSnowflake, posted by Girlnterrupted78 on August 29, 2009, at 0:02:37
Hi Girl:
The thread is "Parnate Rocks, Dueling Drugs"...Fred Potter.. I think.
I agree with Scott that when depression is mediated so is SA. When I'm very depressed my self esteem is so low that I'm afraid to answer the phone, leave my house etc. As I become less depressed these fears leave. I have to get over some things that are purely bad habits, but mostly now I'm pretty confident and outgoing again. Still way to sensitive to perceived rejection, but that might have different origins.
Anyway, yes, SA is MUCH improved!!Yes, the Parnate didn't kick in for me until I added the Nortript, like immediately, the next morning! BAMM!! That's why I call it The BOMB!
I personally would not want to augment Parnate with Abilify.
I think if your pdoc investigates all the info that Scott has provided, he will change his mind. My pdoc has been loosely associated with the U. of Colorado Medical School Psychiatry, Mood Disorders, for over 40 years. He has used MAOIs+SELECT TCAs for all that time without ever having a bad reaction. I totally trust him.
Also, when I was having a hard time with fatigue during the day he said I should try taking the Parnate at night! I was afraid to do that, but I think it would be worth a try for you. It wouldn't hurt you. Once I forgot my afternoon dose and took 30mgParnate at 10 or 10:30pm along with my nighttime Nortript. I went right to sleep at 12 midnight which is my usual bedtime (right after Charlie Rose) with no problem. So, I think you could try anything with your Parnate dosing and see what works for you. I don't think Parnate is very sensitive to time like some other drugs. I usually do start feeling a little tired when it's time to take my afternoon dose, but not terribly so.
I think it takes time for the body to get used to Parnate. I am continuing to feel better little by little, even now after 4 months. I had a setback with the trial, but I've popped right back after a couple days of sleep and a massage!! I think it will get better and better as I learn more about tweaking it, and it settles in.
"Parnate will always work if you work with it" I read that somewhere, written by a pdoc, and it's become my mantra.
This board has helped me enormously with Parnate. I have learned so much about Parnate (and lots of other things) and had such amazing support and suggestions, that I'm not sure I would have been successful without these wonderful people. (ok ok, I'll stop now)
I think I answered your questions, but if I can help anymore by sharing my experience, I'd be happy to.
Good luck!
Gayle
Posted by Girlnterrupted78 on August 30, 2009, at 6:25:52
In reply to Re: How long for Parnate::Coloradosnowflake req'd, posted by ColoradoSnowflake on August 29, 2009, at 0:50:12
Hi again Gayle, and thanks so very much for the ongoing support and sharing of info! I really do appreciate your help.
> The thread is "Parnate Rocks, Dueling Drugs"...Fred Potter.. I think.
Yeah, I finally found it. From reading you comments there, it appeared to me like the fatigue didn't dissipate on its own with time. Rather, you were able to counter it with caffeine + Provigil? Is this correct? I, unfortunately, cannot afford Provigil, so I guess will get back to you guys, letting you know if the fatigue ever disappears on its own. Lots of the side-effects I had while on Nardil disappeared, so I'm hoping this will happen with Parnate as well. Keeping my fingers crossed!
> I agree with Scott that when depression is mediated so is SA. When I'm very depressed my self esteem is so low that I'm afraid to answer the phone, leave my house etc. As I become less depressed these fears leave. I have to get over some things that are purely bad habits, but mostly now I'm pretty confident and outgoing again. Still way to sensitive to perceived rejection, but that might have different origins. Anyway, yes, SA is MUCH improved!!
That's great to hear. Social anxiety has been a huge impediment in my life and I just can't wait to find something that will truly make a difference and allow me to finally enjoy human interactions to the fullest. It's been a nightmare so far, to know I'm in the right place, at the right time, with the right people, but with a disability that keeps a wall apart from forming the meaningful relationships that I crave. I know I can do it. I did it on Celexa. I just need another med that will work on my rejection sensitivity and give me the confidence to be myself. It was the best feeling I had felt in my whole life and lasted one year only. I cherish those memories.
> Yes, the Parnate didn't kick in for me until I added the Nortript, like immediately, the next morning! BAMM!! That's why I call it The BOMB!
Oh, now I understand. So it's not like it took the whole 3 months for Parnate to kick in. It simply never kicked in on its own, but kicked in immediately when it was augmented? I had misunderstood your previous comments. If it didn't kick in on its own in 3 months, it probably would have never done it on its own, right? Because it doesn't take so long for MAOIs to act. Isn't it 3-8 weeks? If the augmenter did it immediately, then sounds like Parante alone might not have been enough for you. That info's good to know. I will ensure I get some serious augmenters if for any reason Parnate doesn't kick in to the fullest.
> I personally would not want to augment Parnate with Abilify.
Oh really? Would you mind elaborating why? Thanks a lot, that'd be valuable information for me and my pdoc.
> I think if your pdoc investigates all the info that Scott has provided, he will change his mind.
Really? What kind of information? Do you have a specific link where I can find that information? My doctor is a research psychiatrist at Columbia University in New York City. He's supposed to be top notch in his field. Four years ago, I already tried Abilify to augment an SSRI and it gave me akathisia, daytime drowsiness, and of course, no antidepressant effect. So it was pretty horrible altogether and discourages me from trying Abilify again. But I also wonder if maybe it will behave differently combined with an MAOI?
> Also, when I was having a hard time with fatigue during the day he said I should try taking the Parnate at night!
Yeah, just last night, I took it upon myself to do just that. I took it at 6:30pm and then at 10:30pm. I will give it a few days and see how it turns out. But just for this first time, I did notice some good things: Very low to almost no hypotension, and almost no fatigue. So I guess I could be hypotension free or close to it, if I take the dose at night, but I'll have to keep doing this for long enough to find out if it's sustainable.
> I had a setback with the trial, but I've popped right back after a couple days of sleep and a massage!! I think it will get better and better as I learn more about tweaking it, and it settles in.
Oh really? Sorry to hear that, but glad to hear you're back on track. Have you started tweaking it or making changes? Let us know if any of those changes produce some positive results. Thank you!
> I think I answered your questions, but if I can help anymore by sharing my experience, I'd be happy to.
Yes, you did answer everything, and so graciously, thank you so much for all this helpful info!
The only last question I would want to ask you is if you could direct me to the links you referred me above (by scott, I believe) regarding nortriptyline augmentation, and your reasoning behind Abilify not being a good idea as an augmenter.
Thanks again for your invaluable help!
GI
Posted by Nadezda on August 30, 2009, at 13:06:31
In reply to Re: How long for Parnate to reach full effect » ColoradoSnowflake, posted by Girlnterrupted78 on August 30, 2009, at 6:25:52
> I personally would not want to augment Parnate with Abilify.
Oh really? Would you mind elaborating why? Thanks a lot, that'd be valuable information for me and my pdoc.
> I think if your pdoc investigates all the info that Scott has provided, he will change his mind.
Really? What kind of information? Do you have a specific link where I can find that information? My doctor is a research psychiatrist at Columbia University in New York City. He's supposed to be top notch in his field. Four years ago, I already tried Abilify to augment an SSRI and it gave me akathisia, daytime drowsiness, and of course, no antidepressant effect. So it was pretty horrible altogether and discourages me from trying Abilify again. But I also wonder if maybe it will behave differently combined with an MAOI?
~~So, could you elaborate on why you or Scott doesn't think augmenting parnate-- or how about another Maoi-- with abilify is a good idea?
I take abilify with Emsam and have found it useful and have no other problems.
I don't know who GirlInterrupted is seeing at Columbia, but I'm seeing a very highly regarded pdoc at Payne Whitney and he also suggested abilify with Parnate and Emsam.
Nadezda
Posted by ColoradoSnowflake on August 30, 2009, at 15:33:00
In reply to Re: How long for Parnate to reach full effect, posted by Nadezda on August 30, 2009, at 13:06:31
Posted by Girlnterrupted78 on August 31, 2009, at 8:24:24
In reply to Ignore my remark about Abilify. I'm ignorant.Sorry (nm), posted by ColoradoSnowflake on August 30, 2009, at 15:33:00
Do you happen to have that info, though, the studies you mentioned about Nortriptyline as augmentor to Parnate?
If you do have them, they would be greatly appreciated.
Thanks
Posted by ColoradoSnowflake on September 1, 2009, at 9:54:51
In reply to Re: How long for Parnate to reach full effect » ColoradoSnowflake, posted by Girlnterrupted78 on August 31, 2009, at 8:24:24
> Do you happen to have that info, though, the studies you mentioned about Nortriptyline as augmentor to Parnate?
>
> If you do have them, they would be greatly appreciated.
>
> Thanks
Scott posted a list of sites/links within the last month. Sorry I don't know exactly which post. Gayle
Posted by SLS on September 1, 2009, at 10:32:04
In reply to Re: How long for Parnate to reach full effect » Girlnterrupted78, posted by ColoradoSnowflake on September 1, 2009, at 9:54:51
Here is a list that Maxime posted.
I will probably have a difficult time locating my post with citations.
http://www.dr-bob.org/babble/20090801/msgs/911205.html
- Scott
Posted by SLS on September 1, 2009, at 10:48:11
In reply to Re: How long for Parnate to reach full effect, posted by SLS on September 1, 2009, at 10:32:04
> Here is a list that Maxime posted.
>
> I will probably have a difficult time locating my post with citations.
>
> http://www.dr-bob.org/babble/20090801/msgs/911205.html
Here is the post that was referred to:http://www.dr-bob.org/babble/20090818/msgs/913928.html
- Scott
Posted by FredPotter on September 1, 2009, at 18:10:16
In reply to Re: How long for Parnate to reach full effect, posted by SLS on September 1, 2009, at 10:48:11
Has anyone tried a maintenance dose of Parnate? ie 10mg every alternate morning with nortriptyline 50mg in the evening. I took up to 50mg of Parnate over 6 weeks before this
This is the end of the thread.
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