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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Sunbath on September 10, 2009, at 6:00:56
Hi,
sorry, one might think there are enough parnate threads already :D
I got extremely lucky with my new pdoc. She's really great and open for anything that makes sense..
As I already mentioned Parnate isn't available in my country and so it isn't covered by ANY insurance and I doubt that any doctors are prescribing it on a regular basis..However I just got my package and can't wait to start it. University is starting very soon again and I'm so afraid. I really want to function by then having already lost too much of my lifetime hanging around in my room not doing anything because of lack of energy and anxiety.. some generalized anxiety issues + social anxiety + ocd.
I've been on 50mg Sertraline for about 6 weeks. I know it's BY FAR not enough time to deem it a faulty trial, but prior I've been on escitalopram for about a year and it wasn't helping and having tried so many ssris/snris over the last years, I simply don't have much hope in sertraline helping so much (this time, already tried it a few years back) that it would suffice.
This I told her and so we decided to ditch sertraline in favour of a parnate trial (because I really don't want to wait another 6 weeks while increasing dosages of sertraline when it's unlikely to produce an effect big enough).Yesterday I only took 25mg of it, but today I quit cold turkey.
In the literature it's often mentioned that at least 5 half lifes of the sri drug should pass before starting a MAOI and parnate in particular.
Also it's mentioned that after a single dose of 10mg-20mg MAO activity would drop to ~20% after 24h.
Sertraline's half life is known to be between 22 and 36 hours (interindividual differences).Would you think waiting 5 days after having quit cold turky would be enough?
I ask because she told me to slowly reduce the dose and start taking 10mg parnate after 1 week. So I guess I'm winning some time when I go cold turkey. Also being that interactions between ad drugs + parnate are often greatly exaggerated (amitriptyline is often mentioned to be safe with parnate), I really wonder if after having quit 50mg Sertraline for 5 days, the reuptake menchanism left would be stronger than the 5htt blocking potenty of amitriptyline?Also 10mg Parnate is a really low dose.. hmm..
Sorry maybe I'm talking b*llsh*t, also only because it's mentioned somewhere in the literature doesn't mean it's safe for everyone.. please don't take any of those things I mentioned serious, I'm just so eagerly waiting to start it and I don't want to be so long without an AD..
What do you think?Are 5 days enough?
Posted by Maxime on September 10, 2009, at 9:29:26
In reply to Now trying it too.. how long washout?, posted by Sunbath on September 10, 2009, at 6:00:56
The recommended time is usually 2 weeks. I think 5 days is too soon. The last thing you want to have is serotonin syndrome which is really awful. I waited about 4 days when coming off Zoloft (my doc said that was long enough). I had an awful reaction. It's best to be on the safe side. I know it's hard, because I am going through it right now myself. Maybe we can do it together?
Posted by Phillipa on September 10, 2009, at 12:16:47
In reply to Re: Now trying it too.. how long washout? » Sunbath, posted by Maxime on September 10, 2009, at 9:29:26
Sunbath Maxime knows her stuff I'd listen to her and being buddies would help you both and good luck by the way. Phillipa
Posted by Sunbath on September 10, 2009, at 17:34:32
In reply to Now trying it too.. how long washout?, posted by Sunbath on September 10, 2009, at 6:00:56
Thanks a lot Maxime and Philippa for your replies!
You are right of course!
thank you very very much, yes let's do it together!
But I won't wait the full 14 days (only 50mg of sertraline?!).. When are you going to start it?Just before you are leaving to Calgary or later?(just read your thread) Then I'd also start it the 18th/19th.. How are you doing by now? Is it bearable? I find it very remarkable that you are able to push yourself so hard to get up and going and visiting your friend in the mountains! You seem to be really strong! Are you also going to ride horses? It's surely the best thing to do to get past this awful period until the parnate kicks in!
I'm just starting to feel some strange dizziness and slightly increased anxiety.. I also got a cold yesterday so I dunno exactly which symptoms come from that or the withdrawal. I'm really lucky that I'm not that depressed!
Sorry I'm not so good in English and I don't know so many words necessary :( But I just wanted to say that I'm feeling with you! Keeping my fingers crossed! In the end you will succeed, I'm sure! Try to not let the depression fool around with you as it likes!!!Have a good evening! Good nite and greetings from Austria :)
Posted by Maxime on September 10, 2009, at 17:44:45
In reply to Re: Now trying it too.. how long washout?, posted by Sunbath on September 10, 2009, at 17:34:32
Your English is fine. :)
I will only be starting Parnate on October 6. My pdoc is on holiday and then I will be away in Calgary for two weeks. I'm going to spend some R&R time in the mountains and working with my friend's horses. I won't be able to ride them because they are not trained for riding.
My mood has been terrible. I cry at the drop of a hat and I am thinking of suicide all the time. I don't think it's totally from withdrawing from the Cymbalta. I was feeling pretty rough beforehand and that is why I am switching to Parnate since I had a good response to it in the past. I hope it will be the same this time.
Good luck to you!
Posted by emmanuel98 on September 10, 2009, at 20:31:23
In reply to Re: Now trying it too.. how long washout? » Sunbath, posted by Maxime on September 10, 2009, at 17:44:45
When I went on parnate recently, the hospital where I was waited 10 days for prior drugs to washout. My own p-doc recommended two weeks. But 5 days is surely not long enough.
Posted by ColoradoSnowflake on September 10, 2009, at 21:28:06
In reply to Re: Now trying it too.. how long washout?, posted by Sunbath on September 10, 2009, at 17:34:32
Sunbath:
I waited two weeks for my washout and I'm glad I did because I felt horrible on Parnate for several weeks. And I do mean horrible. But the side effects eventually went away, and it was worth it.So I hope you will wait and give the Parnate and yourself a fair start!
Your English is extremely good!
Gayle
Posted by Sunbath on September 11, 2009, at 14:02:28
In reply to Re: Now trying it too.. how long washout? » Sunbath, posted by Maxime on September 10, 2009, at 17:44:45
> Your English is fine. :)
haha I really can't understand why, but thanks for this flattering comment :)
> I will only be starting Parnate on October 6. My pdoc is on holiday and then I will be away in Calgary for two weeks. I'm going to spend some R&R time in the mountains and working with my friend's horses. I won't be able to ride them because they are not trained for riding.
Oh I see, but this sounds quite interesting! Is your friend training them so that one can ride on them or is she doing something different with the horses?
> My mood has been terrible. I cry at the drop of a hat and I am thinking of suicide all the time. I don't think it's totally from withdrawing from the Cymbalta. I was feeling pretty rough beforehand and that is why I am switching to Parnate since I had a good response to it in the past. I hope it will be the same this time.:( that's very sad to hear! But it's kind of logical of course.. going off cymbalta isn't doing your brain chemistry any good I'm sure and that's making everything even worse! Just try not to think that it's you, it's the depression + cymbalta withdrawal and you can fight it and you will soon with the help of parnate.
BTW: I read you tried to go all alternative once.. did you try rhodiola too?
I wasn't very optimistic about my doc prescribing parnate so that I decided to go all alternative for the 1st time if he wasn't to prescribe it.
So I ordered New Chapter Rhodioloa Force 300mg capsules from vitacost.com. The biggest concern being anxiety and sleep troubles, I also ordered Gaia Herbs' Kava Kava capsules (extra strength, 225mg kavalactones) and Seriphos (phosphorylated serine). I wanted to try them all when I was going to stop any medication.
They all arrived 2 days ago and I just HAD to try them today! The rhodiola really seems to work! and as many ppl mentioned it works immediately!!
I seem to have more energy, less anxiety and my mood is MUCH better, although I quit the SSRI cold turkey and I'm having a cold!!! Before I had a meeting which I was VERY afraid of and was ruminating about it for 2 weeks, but it was NO problem at all and I felt even a bit confident ( I really really never feel confident, especially not in situations like this where I don't know the ppl I talk to (the very opposite is true) ).I really think the rhodiola is having a great impact and I would stick to it if I hadn't the opportunity to try parnate (and hadn't heard about some kind of tolerance possible with rhodiola..)!
I don't know if rhodiola can be combined with parnate and I don't know whether I should stay clean of rhodiola for 14 days either before starting parnate.. Do you know anything about it?
I'll aks in the alternative board too..
If it is ok to take, I'll continue using it until the parnate trial starts and I would HIGHLY recommend it to you too!The Kava btw, which is sad, isn't doing anything at all :(
Additionally I'd like to mention that my grandmother who's husband died 1 year ago and who is/was VERY depressed until now seems to react to rhodiola very positively too!! Before she tried sertraline which helped her with bad "over emotionality" and lifted her mood somewhat but she stayed very lethargic and couldn't work and was tired all days the whole day trough.. Then she quit sertraline, because she thought it was the cause of her tiredness (after 3 month being on) and started a very high dose (1200mg/day) of a popular brand of St. Johns Wort (ws 5570). She was taking it for 2 month without any improvement (still felt EXTREMELY unmotivated.. everything was a big obstacle and took all her strength to get accomplished even the smallest things). She also was sleeping very poorly since a few months..
2 days before she got 2 caps of "rhodiola force 300" + 1 cap 100mg Seriphos from me which she took before nighttime (the seriphos) and 30 minutes before breakfast on the next day (the 2 caps rhodiola). At midday she phoned me being euphoric, nearly hypomanic!!! She told me that she hadn't slept so good since month and that she never felt that "normal" and motivated since 1 year and that it was the first time she enjoyed doing housework again!I really don't think that it was placebo as she tried many different things before (valerian, hops, omega 3 fatty acids, and last but not least the St. John's Wort...) and she never had a positive reaction to one of them...
Just wanted to tell you in the case you haven't tried it and in case it is ok to take before the parnate trial.. maybe it could help you too getting through this very difficult time!
> Good luck to you!Thank you!!! And all the best to you, keeping my fingers crossed for you!
Posted by Sunbath on September 11, 2009, at 14:06:59
In reply to Re: Now trying it too.. how long washout?, posted by ColoradoSnowflake on September 10, 2009, at 21:28:06
Thanks so much for your input Gayle!!
Yes you have convinced me (all of you), 5 days is too little time.. But being on only 50mgs of sertraline I suspect 10days would be enough, no? (My pdoc wanted 7 days inclusive the washout)
So I'd start on the 19th... what do you think? I mean someone on 200mg Sertraline waiting 14 days would be fine too, would he?Are you doing fine with your increased dosage of Parnate?
Greeeeets,
Sunbath
Posted by Sunbath on September 11, 2009, at 14:07:46
In reply to Re: Now trying it too.. how long washout?, posted by emmanuel98 on September 10, 2009, at 20:31:23
Posted by JohnJ777 on September 12, 2009, at 12:34:20
In reply to Re: Now trying it too.. how long washout? » Maxime, posted by Sunbath on September 11, 2009, at 14:02:28
> So I ordered New Chapter Rhodioloa Force 300mg capsules from vitacost.com. The biggest concern being anxiety and sleep troubles, I also ordered Gaia Herbs' Kava Kava capsules (extra strength, 225mg kavalactones) and Seriphos (phosphorylated serine). I wanted to try them all when I was going to stop any medication.Take your new found love of the Rhodiola to the next step. You're using a store brand. Try a therapeutic brand, like the MIND BODY & SPIRIT which is mentioned here by other posters. That's often sold by psychiatrists or other doctors, but you can also buy it on the internet. There's a rhodiola store called proactivebio.com - I've used Rhodiola force and it is OK but the effect of a full spectrum rhodiola is quite improved, well worth the difference. Don't buy Rhodiola on a "how many MG in the capsule" basis! Buy Siberian, and always full spectrum, particularly the therapeutic brands (there are a few).
Posted by Sunbath on September 12, 2009, at 13:26:54
In reply to Re: Now trying it too.. how long washout?, posted by JohnJ777 on September 12, 2009, at 12:34:20
Thank you very much for telling me this!
At the moment I have stopped my rhodiola trial because I want to feel my "normal" self and the full spectrum of my conditions before starting the parnate.. otherwise I can't tell exactly what's improving.
Also I still haven't gotten any answer to my question regarding the use of MAOIs together with rhodiola (i.e. if there's also a washout necessary). So I won't use it again till I know more about that. Do you maybe happen to know anything about this?Also I need to re trial the kava one day.. maybe I haven't taken enough of it (only 1 capsule)
But I really have to slow down, I shouldn't try all that the same time, maybe I was a little hypomanic.
I regret ordering the supplements at this time (I was so negative about the chance of the possibility my pdoc would prescribe parnate)When I order some rhodiola again I'll definately look for those "therapeutic brands". Also thank you for the link to that shop!
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