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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 18 to 42 of 42. Go back in thread:
Posted by ColoradoSnowflake on December 16, 2009, at 21:11:51
In reply to Re: Parnate - 60mg isn't enough, posted by kirbyw on December 16, 2009, at 0:14:44
Rick:
How do you get away with doing such a small dose of Parnate??? Have you always taken such doses? I know you said you would go off of it for awhile then on again? It killed me getting on it...5 months of feeling HORRIBLE! It makes me wonder if maybe it's not good for me.
Did you ever have to take larger amounts? Add other drugs..anything like that?
Sounds like you had a lot of guts and determination to keep working when you were depressed...and no one knew it.
I think a lot of us know just how that feels.This drug has confused me from the get-go. Nothing about it makes sense to me.
At least I don't get insomnia from it. Do you? I can't remember.Thanks for your interest and suggestion!
Gayle
Posted by ColoradoSnowflake on December 16, 2009, at 21:23:37
In reply to Re: Parnate - 60mg isn't enough, posted by zana on December 16, 2009, at 17:58:38
Hi Maxie and Zana:
Thanks for your kind condolences. It really is a bitch. Now I'm the only living, breathing thing in the house....pretty creepy.
I'm just putting one foot in front of the other to get through all my houseguests/parties/activities, in one piece, and deal with the meds again in January.
I hope you guys are doing well.
Maxie, do you have any complaints about the Parnate? Do you have a "chemical" feeling? or "out of your body" feeling? Just wondering.Thanks again and take care,
Gayle
Posted by Phillipa on December 16, 2009, at 22:01:55
In reply to Parnate: maxine and zana, posted by ColoradoSnowflake on December 16, 2009, at 21:23:37
Gayle wow you do have a lot of autoimmune never heard of it effecting autoimmune have you googled that? I feel for you. So the doc says stay on it. You are doing so great in managing to function and all the other ordeals your're dealing with. Please feel better soon? Love Phillipa
Posted by Maxime on December 16, 2009, at 22:21:34
In reply to Parnate: maxine and zana, posted by ColoradoSnowflake on December 16, 2009, at 21:23:37
> I hope you guys are doing well.
> Maxie, do you have any complaints about the Parnate? Do you have a "chemical" feeling? or "out of your body" feeling? Just wondering.
>
> Thanks again and take care,
>
> Gayle
>No complaints at all about the Parnate. Sometimes I feel a bit speedy on it but that's it. The Nortriptyline is causing an awful taste in my mouth which is turning me off the little food I was eating. All in all, I am doing really well!
Posted by kirbyw on December 17, 2009, at 0:47:05
In reply to Re: Parnate - 60mg isn't enough, posted by ColoradoSnowflake on December 16, 2009, at 21:11:51
> Rick:
>
> How do you get away with doing such a small dose of Parnate??? Have you always taken such doses? I know you said you would go off of it for awhile then on again? It killed me getting on it...5 months of feeling HORRIBLE! It makes me wonder if maybe it's not good for me.
>
> Did you ever have to take larger amounts? Add other drugs..anything like that?
>
> Sounds like you had a lot of guts and determination to keep working when you were depressed...and no one knew it.
> I think a lot of us know just how that feels.
>
> This drug has confused me from the get-go. Nothing about it makes sense to me.
> At least I don't get insomnia from it. Do you? I can't remember.
>
> Thanks for your interest and suggestion!
>
> Gayle
Gayle
Its interesting that back in the 80's many PDocs thought that 30 mg was the maximum safe dose for Parnate, although in fact my Doctor frequently had me on 50 to 60 mg after my hospitalization which was in 1982.Actually I have had problems with insomnia this time around at doses above 30 mg. I would like to be on 40 mg. Also I have interactions with my heart medication, if I take higer doses of Parnate I feel really wiped out, tired with low blood pressure, etc. I have good days when 20 or 30 mg seems just about right, and then I have the bad days when I feel like 40 or 50 would be better. That's part of the reason i am now trying Lithium with Parnate. Its complicated. Thanks for responding to my posts.
Rick
Posted by ColoradoSnowflake on December 17, 2009, at 21:07:32
In reply to Re: Parnate: maxine and zana, posted by Maxime on December 16, 2009, at 22:21:34
Posted by ColoradoSnowflake on December 17, 2009, at 21:13:52
In reply to Re: Parnate - 60mg isn't enough, posted by ColoradoSnowflake on December 16, 2009, at 21:11:51
Rick:
I'm really interested in how you do with Parnate and lithium.
Please keep us posted!
Good luck!
Thanks,
Gayle
Posted by Doric on December 18, 2009, at 14:18:53
In reply to Re: Parnate - 60mg isn't enough » Doric, posted by ColoradoSnowflake on December 16, 2009, at 20:10:01
Hello Gayle,
We appear to have very similar symptoms indeed, especially regarding fatigue (I cant take anything that can cause sedation) and staying up late at nightproblems which I have managed to overcome at least for nowby reducing the Parnate and adding in a psycho-stimulant. I can dose at 10p.m. in the evening and still get a good nights sleep.
I have melancholic depression, ADD inattentive and sleep apnoea-each condition clinically diagnosed (just call me action Jackson). Its not difficult for you to see that while these conditions can be separately identifiedthat they are all inextricably linked by a thousand threads. I mention this as I only realized I had ADD about 14 months ago and after seeking treatment for it, it has helped a great deal in making sense out of what each medication is doing, and identifying which symptoms are associated with which conditions.
Parnates role is in treating mood and DexA restores physical and mental agility. If I just take the Parnate alone-the depression is alleviated, but the lethargy persists. If I take pyschostimulants on their own, they restore physical function, but the side effects are unbearableand they do little, if anything at all to improve mood. But when administered concurrently, the Parnate overrides the side effects of the pyschostimulants, while the pyschostimulants boost the mood elevating properties of the Parnate.
The inability or difficulty in actually going to bed and getting sleep, for someone suffering from pronounced fatigue, is very prevalent amongst ADD suffers. (http://www.psychiatryupdate.com.au/article/sleep-continuity-and-adhd-may-be-genetically-linked/463393.aspx).
My doctor was not surprised in the least to find that taking stimulants late into the night actually enhanced sleep, because they clear mind traffic and allow you to relax. The problem with Parnate was that I had to have high doses to achieve remission that left me overheated and wired. Introducing pyschostimulants has allowed me to reduce the dose to an acceptable level.
Good luck
Posted by Doric on December 18, 2009, at 15:36:55
In reply to Re: Parnate - 60mg isn't enough, posted by Doric on December 18, 2009, at 14:18:53
PS. Thanks for sharing your experience with Nortryptine, you confirmed my concerns about sedation.
I will requesting a script for Abilify this week for its stimulant and single daily dosing as an
Posted by Maxime on December 19, 2009, at 22:10:35
In reply to Re: Parnate - 60mg isn't enough, posted by Doric on December 18, 2009, at 15:36:55
Hi Gayle
Have you thought about changing the Provigil for something like Adderall XR. I took adderall to augement Parnate in 2002 and it worked really well.
I guess you still have to play around with dosages.
Hang in there.
Posted by ColoradoSnowflake on December 20, 2009, at 12:47:30
In reply to Re: Parnate - 60mg isn't enough, posted by Doric on December 18, 2009, at 14:18:53
Hi Doric:
I didn't want you to think I am ignoring your posts. I think you're right on that we have very similar depressions. I always thought I had so much anxiety that it wore me out, but I guess there is more to to my horrible fatigue than that.
Thanks for your suggestions. I would like to compare notes later, but I'm on overwhelm right now and focusing on getting through the next week.
I also have ADD (so does one of my sons and my father did as well)....I have the female version. I don't have sleep apnea that I know of.
Take care,
Gayle
Posted by ColoradoSnowflake on December 20, 2009, at 13:27:20
In reply to Parnate - 60mg isn't enough, posted by ColoradoSnowflake on December 15, 2009, at 0:05:32
I've gotten so depressed since my dog died and Xmas is closing in on me. I just had a big molar pulled and a cavity filled (which I blame on the Parnate dry mouth because I have good teeth).
My son with the newborn, and 16month old and 15 yr old son and wife will be here later today. I am on overwhelm. I have GOT to get the house somewhat ready and some food as well.
Yesterday afternoon I took a 7th Parnate because I was so depressed. I felt better right away. BUT, today I am dizzy, bumping into furniture, door jambs etc., itching and chilling worse. I live in a two story house with a finished basement and I run up and down the stairs all the time. Now I'm afraid. I'm trying to be really really careful, especially on the stairs. I do NOT want to fall again. I don't have the time or energy for any of that kind of drama.
I'm going to stick with 60mg Parnate. I think some of what it causes me is an allergic reaction (itching, chills ) and it makes my R.A. worse which sucks bad because I'm having so much trouble with my hands/feet/elbows...Bad hands are the pits if you have anything to do.
I think I'll up the Provigil to 200-250mg. I can't up the Nortrip. because it makes me so tired and adds to my unsteadiness.
I lived on booze and dexedrine for many years of my life. They worked wonderfully well. But, They both ended up turning on me so badly that I'm kind of afraid of either one of them.My adult hyper son takes Adderall and it is a lifesaver for him. I've got so much on my plate right now I'll wait until later to think about changing the Provigil. But I really do appreciate the suggestions.
I guess right now I have to calm my anxiety (no benzo's...make me too sleepy), and walk through the next 10 days as best I can).
I have to remember how lucky I am that my kids still like me and want to come (with all their entourages!) home for Christmas. I have to focus on that.
Maxie, I am so happy that you are in such a better place now!! I think adding the nortript really is a synergist with parnate and makes the whole thing work better, don't you? You worked really long and hard to get here. Bravo!Hope you all have as good of holidays as possible.
Hugs to everyone,
Gayle
Posted by SLS on December 20, 2009, at 14:49:44
In reply to Tried 70mg. EEK, posted by ColoradoSnowflake on December 20, 2009, at 13:27:20
Did you feel MORE dizzy this time than you did when you had been at 80mg steadily?
- Scott
Posted by SLS on December 20, 2009, at 15:06:52
In reply to Tried 70mg. EEK, posted by ColoradoSnowflake on December 20, 2009, at 13:27:20
If Parnate doesn't work out for you, perhaps your doctor would consider using Marplan since you seem to be a MAOI responder. Nardil might produce even more hypotension than Parnate. I still think you should try adding Florinef for awhile in the hope that your body will adjust to the Parnate.
I hope the holiday season brings you at least some joy. If not, just remember that it is not your fault. You are doing the best you can with what you have to work with. Besides, I am sure that you still bring joy to those around you no matter how horrible you may feel.
- Scott
Posted by floatingbridge on December 21, 2009, at 2:02:19
In reply to Re: Parnate - 60mg isn't enough, posted by Doric on December 18, 2009, at 14:18:53
> Hello Gayle,
>
> We appear to have very similar symptoms indeed, especially regarding fatigue (I cant take anything that can cause sedation) and staying up late at nightproblems which I have managed to overcome at least for nowby reducing the Parnate and adding in a psycho-stimulant. I can dose at 10p.m. in the evening and still get a good nights sleep.
>
> I have melancholic depression, ADD inattentive and sleep apnoea-each condition clinically diagnosed (just call me action Jackson). Its not difficult for you to see that while these conditions can be separately identifiedthat they are all inextricably linked by a thousand threads. I mention this as I only realized I had ADD about 14 months ago and after seeking treatment for it, it has helped a great deal in making sense out of what each medication is doing, and identifying which symptoms are associated with which conditions.
>
> Parnates role is in treating mood and DexA restores physical and mental agility. If I just take the Parnate alone-the depression is alleviated, but the lethargy persists. If I take pyschostimulants on their own, they restore physical function, but the side effects are unbearableand they do little, if anything at all to improve mood. But when administered concurrently, the Parnate overrides the side effects of the pyschostimulants, while the pyschostimulants boost the mood elevating properties of the Parnate.
>
> The inability or difficulty in actually going to bed and getting sleep, for someone suffering from pronounced fatigue, is very prevalent amongst ADD suffers. (http://www.psychiatryupdate.com.au/article/sleep-continuity-and-adhd-may-be-genetically-linked/463393.aspx).
>
> My doctor was not surprised in the least to find that taking stimulants late into the night actually enhanced sleep, because they clear mind traffic and allow you to relax. The problem with Parnate was that I had to have high doses to achieve remission that left me overheated and wired. Introducing pyschostimulants has allowed me to reduce the dose to an acceptable level.
>
> Good luck
>
>Doric
Thanks for the link and also the connection between add and sleep. Insightful and invaluable info to me. Has me thinking. I sleep great after a day of dexadrine.
Question: are there any links between some add and exposure to prolonged childhood stress?
best,
fb
Posted by floatingbridge on December 21, 2009, at 2:04:18
In reply to Re: Parnate - 60mg isn't enough, posted by Doric on December 18, 2009, at 15:36:55
Doric,
File this under advice: what dose will you be starting abilify at? I found small doses to be very effective (2mg).
fb
> PS. Thanks for sharing your experience with Nortryptine, you confirmed my concerns about sedation.
>
> I will requesting a script for Abilify this week for its stimulant and single daily dosing as an
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Posted by mtdewcmu on December 22, 2009, at 21:49:02
In reply to Tried 70mg. EEK, posted by ColoradoSnowflake on December 20, 2009, at 13:27:20
Maybe you should consider dumping the nortriptyline and switching to another drug with similar effects. Nortriptyline will add to your hypotension. There are other norepinephrine agonists like Strattera that have fewer side effects.
Posted by SLS on December 23, 2009, at 5:01:11
In reply to Re: Tried 70mg. EEK » ColoradoSnowflake, posted by mtdewcmu on December 22, 2009, at 21:49:02
> Maybe you should consider dumping the nortriptyline and switching to another drug with similar effects. Nortriptyline will add to your hypotension. There are other norepinephrine agonists like Strattera that have fewer side effects.
It has been my experience that the hypotension that is produced by adding nortriptyline to Parnate dissipates within 3 months.
Strattera put me to sleep and produced fatigue for the entire time I took it. I experienced no improvement in depression with it.
When I first began taking nortiptyline, it made me sleep for two days. Thereafter, it had no subjective effect on sleep and there was no somnolence.
If switching from nortriptyline to Strattera does not produce positive results, and nortriptyline is deemed inappropriate, I would consider trying desipramine, as it is less likely to produce persistent somnolence and sedation.
- Scott
Posted by mtdewcmu on December 23, 2009, at 7:41:47
In reply to Re: Tried 70mg. EEK, posted by SLS on December 23, 2009, at 5:01:11
> > Maybe you should consider dumping the nortriptyline and switching to another drug with similar effects. Nortriptyline will add to your hypotension. There are other norepinephrine agonists like Strattera that have fewer side effects.
>
<snip>
> Strattera put me to sleep and produced fatigue for the entire time I took it. I experienced no improvement in depression with it.
<snip>When I took Strattera, there was a slight benefit, accompanied by a marked increase in the sweating I was already experiencing from the Celexa. But Colorado's experience may differ.
I just threw out Strattera because it was the only NRI I could think of that's sold in the US. Isn't there anything else she could try adding to Parnate?
Posted by SLS on December 23, 2009, at 7:46:46
In reply to Re: Tried 70mg. EEK, posted by mtdewcmu on December 23, 2009, at 7:41:47
> I just threw out Strattera because it was the only NRI I could think of that's sold in the US. Isn't there anything else she could try adding to Parnate?
Wellbutrin, perhaps.
- Scott
Posted by floatingbridge on December 23, 2009, at 10:33:36
In reply to Re: Tried 70mg. EEK, posted by SLS on December 23, 2009, at 7:46:46
a chance that Wellbutrin might work when strattera had too many side effects?
(Sorry Gayle for the thread hijack....)
fb
Posted by ColoradoSnowflake on December 23, 2009, at 14:22:54
In reply to Scott +mtdewmcu » SLS, posted by floatingbridge on December 23, 2009, at 10:33:36
Hi!
My house if full of kids and grandkids and dogs. I've sneaked off for a quick minute.When I came down from 80mg to 60mg parnate it triggered bad SEs for me. Terrible itching all over, bad chills and dizziness. Plus parnate kicks in my rheumatoid arthritis significantly.
Its been a month and I still have all those sides.
Plus I have a little reynauds syndrome (my two sisters have always had it bad) of the autoimmune variety, so I'm cold all the time and have also worn my UGGS to bed!!
I have more memory problems and the balance stuff is just as bad, maybe even worse. I am again feeling really unsteady, lurching around.
I think I'm very ALLERGIC TO PARNATE! That possible fact is freaking me out!
The ONLY AD that ever worked for me was Wellbutrin. I had absolutely zero side effects from it. I was at 450mg for years. It helped me about 65%. I tried just about every add-on out there with bad results.I'm wondering if I could come way down on the Parnate(it's the only drug that's ever hit that deep deep place where the worst fear and suicide reside), and add Welbutrin? I didn't know you could take the two together?? I am also taking 5mg or 10mg (every other night) nortriptyline and that seems to keep the insomnia at bay, so I would keep that. It makes me tired the next day so I don't want to increase it. I also don't want to mess with it because it keeps me from having insomnia!! I'd also need to keep taking Provigil 150-200mg/day.
It doesn't take much Parnate to hit that "spot".
I'm afraid if I don't do something the allergic reaction is going to get worse and worse and I won't be able to take parnate at all! Terrible!What do you'all think?
Is that a possibility???
Got to go....
Hope this season is going ok.
Scott, sounds like the drug switch isn't going well. That's a bummer. But it WILL get better. What a time to be doing all that! Good luck!!Hugs to you all,
Gayle
ps Scott, thanks so very much for the lovely encouragement. I think it's a miracle for most of us that we are alive. That's huge!!
Posted by Phillipa on December 23, 2009, at 20:22:21
In reply to Scott +mtdewmcu +fb Parnate Side Effects, posted by ColoradoSnowflake on December 23, 2009, at 14:22:54
Gayle on any meds for the arthritis and Renaud's if so could the addition of parnate be causing allergic reaction? Sounds like you have an option with the wellbutrin. Sounds very stressful also. Love Phillipa
Posted by floatingbridge on December 23, 2009, at 22:51:02
In reply to Scott +mtdewmcu +fb Parnate Side Effects, posted by ColoradoSnowflake on December 23, 2009, at 14:22:54
Gayle,
I'm curious about you parnate reaction. I'll see if Google turns up any leads. I'm wondering, (and I hesitate to mention it), if an anti-imflamatory diet might help w/ more parnate tolerance. Just a thought--l really don't know....
Hope the holiday chaos is enjoyable!
:-)
fb
Posted by SLS on December 24, 2009, at 5:11:24
In reply to Re: Scott +mtdewmcu +fb Parnate Side Effects, posted by floatingbridge on December 23, 2009, at 22:51:02
Regarding anti-inflammatory treatments, I am trying NAC (n-acetylcysteine), a common food supplement that also promotes the production of the antioxidant, glutathione, in the brain. Some studies report efficacy in treating bipolar disorder. It is currently being looked at for schizophrenia and depression.
- Scott
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