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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by mrm36014801 on November 20, 2015, at 19:29:08
My diagnosis is major depression and my primary symptom is a loss of energy. I've been on Parnate twice in the past and I've just started it again but my reaction seems strange to me. I'm now on 40 mg (20 mg in the morning, 10 mg at 1 pm and 10 mg at 5 pm). Instead of it giving me a bit of energy, as it did in the past, it now does the opposite: it makes me very tired. In addition, it seems to adversely effect my digestion. Has anyone experienced these side effects?
Thank you.
Posted by baseball55 on November 21, 2015, at 19:43:15
In reply to Parnate Makes Me Tired, posted by mrm36014801 on November 20, 2015, at 19:29:08
I have not. Parnate never made me tired and, when I first began it, caused crazy insomnia. Hope you find something that works.
Posted by Christ_empowered on November 21, 2015, at 21:34:24
In reply to Parnate Makes Me Tired, posted by mrm36014801 on November 20, 2015, at 19:29:08
just a wild guess, but...sometimes, stimulants can make people tired, too. some weird dopamine thing (wait for sls on this one).
Maybe a dosage adjustment is in order? can you add an amphetamine or something?
Posted by SLS on November 22, 2015, at 9:37:51
In reply to Re: Parnate Makes Me Tired, posted by Christ_empowered on November 21, 2015, at 21:34:24
> just a wild guess, but...sometimes, stimulants can make people tired, too. some weird dopamine thing (wait for sls on this one).
>
> Maybe a dosage adjustment is in order? can you add an amphetamine or something?Lots of people experience daytime fatigue or sleepiness with Parnate. I have no guess as to why. Your wild guess seems very possible.
Parnate does have amphetamine-like effects. Some people have had success using modafinil (Provigil) or armodafinil (Nuvigil) to combat the sleepiness. Both drugs have a 15 hour half life, which is perfect for the Parnate-induced daytime sleepiness. A single morning dose might be all that is needed. Neither drug is a traditional stimulant. In addition to moderate dopamine reuptake inhibition, they raise levels of histamine in hypothalamus. I'm not sure how, though. It was once thought that modafinil worked through stimulating the orexinergic system. It does affect orexin, but this does not appear to be the mechanism through which the drug acts to promote wakefulness.
- Scott
Posted by mrm36014801 on November 23, 2015, at 19:07:31
In reply to Re: Parnate Makes Me Tired, posted by SLS on November 22, 2015, at 9:37:51
Thank you for all of your responses. My psychiatrist told me to reduce the dose (to just 20 mg in the morning) but it still makes me tired.
I develop a tolerance to both Provigil and Nuvigil quickly and so I cannot take them. What dogs me the most is that I've been on Parnate, twice, in the past, and I had a good reaction both times. If this continues I'll speak with my psychiatrist about Vivactil.> > just a wild guess, but...sometimes, stimulants can make people tired, too. some weird dopamine thing (wait for sls on this one).
> >
> > Maybe a dosage adjustment is in order? can you add an amphetamine or something?
>
> Lots of people experience daytime fatigue or sleepiness with Parnate. I have no guess as to why. Your wild guess seems very possible.
>
> Parnate does have amphetamine-like effects. Some people have had success using modafinil (Provigil) or armodafinil (Nuvigil) to combat the sleepiness. Both drugs have a 15 hour half life, which is perfect for the Parnate-induced daytime sleepiness. A single morning dose might be all that is needed. Neither drug is a traditional stimulant. In addition to moderate dopamine reuptake inhibition, they raise levels of histamine in hypothalamus. I'm not sure how, though. It was once thought that modafinil worked through stimulating the orexinergic system. It does affect orexin, but this does not appear to be the mechanism through which the drug acts to promote wakefulness.
>
>
> - Scott
Posted by Deahoidar on November 29, 2015, at 3:39:28
In reply to Re: Parnate Makes Me Tired, posted by mrm36014801 on November 23, 2015, at 19:07:31
There are a number of things that could be going on.
You are taking Parnate on an interesting schedule. Perhaps you could try altering the times you take your dosing.
Parnate will often disrupt REM sleep and can result in extreme daytime somnolence.
It could also be that this is a side effect that will diminish with time.
I have taken Parnate for over 15 years at various dosings and it has been responsible for keeping me alive. I have found that side effects can often appear and the diminish over time or disappear as the dose is increased. I currently take 140mg all in one dose in the morning. This seems best to avoid the disruption of sleep.
I hope you find a useful regimen that works for you. If you need stimulants for energy, I'm taking 100mg Ritalin in order to overcome the severe Anhedonia and anenergia that comes with sever depression.
Posted by babbler20 on December 1, 2015, at 0:07:34
In reply to Parnate Makes Me Tired, posted by mrm36014801 on November 20, 2015, at 19:29:08
> My diagnosis is major depression and my primary symptom is a loss of energy. I've been on Parnate twice in the past and I've just started it again but my reaction seems strange to me. I'm now on 40 mg (20 mg in the morning, 10 mg at 1 pm and 10 mg at 5 pm). Instead of it giving me a bit of energy, as it did in the past, it now does the opposite: it makes me very tired. In addition, it seems to adversely effect my digestion. Has anyone experienced these side effects?
>
> Thank youYeah it made me insanely tired for the first few weeks with each dose increase. After that it basically stopped me from entering REM sleep as far as I could tell and gave me such bad insomnia that I was exhausted from that as well.
Posted by SLS on December 5, 2015, at 17:14:16
In reply to Re: Parnate Makes Me Tired, posted by babbler20 on December 1, 2015, at 0:07:34
Hi.
> Yeah it made me insanely tired for the first few weeks with each dose increase. After that it basically stopped me from entering REM sleep as far as I could tell and gave me such bad insomnia that I was exhausted from that as well.
Are you still taking Parnate? If not, then what caused you to discontinue it?
How are you?
- Scott
Posted by rose45 on December 8, 2015, at 18:24:06
In reply to Parnate Makes Me Tired, posted by mrm36014801 on November 20, 2015, at 19:29:08
mrm, I have the same problems with it as you do.
I take 30 mg, all in the morning and I often get very sleepy in the afternoons. I try not to eat too much during the day, and that does help sometimes. I have also been having stomach problems, but not quite sure what they are.Queasy stomach. Also, and this is rather embarrassing, I have a body odour since taking parnate (past 2 years). That never happened with nardil, which I was on for 20 years.
Posted by creepy on December 8, 2015, at 22:54:04
In reply to Re: Parnate Makes Me Tired, posted by rose45 on December 8, 2015, at 18:24:06
You may want to look at what you are eating, and whether you are developing insulin resistance.
Sounds kinda similar to something Ive gone through and some of the odd symptoms abated when I stopped eating carbs, bread especially.
I only say that because of the fatigue + body odor thing. if it was just body odor Id just chalk it up to higher body temps and sweating these drugs can cause.
Posted by rose45 on December 9, 2015, at 3:52:24
In reply to Re: Parnate Makes Me Tired, posted by creepy on December 8, 2015, at 22:54:04
creepy, Im sure being careful re. what I eat will make a difference.I eat very little bread anyway, but am experimenting at the moment with different foods. The odour is not just excess sweating, my pee smells strange ... etc. wont go into the details, but just wondered if this happened to others also on parnate. I do worry about the long term effects of these drugs, because when nardil pooped out on me 2 years ago, after 20 years use, I was so much worse than before. But it seems I have no choice but to be on some kind of medication.
I also had the odour problem when I first started nardil, before it really worked, but the problem disappeared once nardil started working.
Posted by mrm36014801 on December 10, 2015, at 19:11:05
In reply to Re: Parnate Makes Me Tired, posted by rose45 on December 9, 2015, at 3:52:24
I am now on 60 mg of Parnate, in two evenly divided doses: one in the early morning and in the early afternoon. However, my impression is that it might be best to take it all in one dose, in the early morning.
It no longer tires me but, rather, is giving me some "energy," which is very helpful. Unfortunately, I now sleep, at the most, for about 3 or 4 hours at night (I can fall asleep but wake up at about 3 am). My psychiatrist has spoken to me of possibly raising the dose higher and he's also spoken to me of possibly putting me on Lunesta for help with sleep (and I'm not wild about)
But, as I say, the medication is helping, and I try my best to follow the diest
Posted by rose45 on December 11, 2015, at 8:27:05
In reply to Re: Parnate Makes Me Tired » rose45, posted by mrm36014801 on December 10, 2015, at 19:11:05
mrm, Im glad that it is beginning to help. In my experience, it took quite a while for me to become accustomed to it. You have to be more strict with cheese etc than you do with nardil. I also had very bad insomnia at the beginning, and had an agreement with my psychiatrist to taper off my sleeping meds. I now take one of 3 different benzos, maybe twice per week, and manage to sleep on the other days, on and off, depending on whether I am really tired or not. All in all, for me parnate has taken some getting used to, but I find it a really good drug, and I only hope that it will last and not poop out.
Posted by Lamdage22 on December 11, 2015, at 9:43:27
In reply to Re: Parnate Makes Me Tired » mrm36014801, posted by rose45 on December 11, 2015, at 8:27:05
Posted by bkva23 on January 7, 2016, at 20:58:10
In reply to Re: Parnate Makes Me Tired, posted by rose45 on December 8, 2015, at 18:24:06
Parnate def made me weak and sleepy as well.I tried caffiene to no avail,it wasnt to i addd a low dose of pysho stimulant ritalin to te mix that not only did the fatique totaly lift but the parnate worked 10 fold.
Posted by rose45 on January 8, 2016, at 2:21:27
In reply to Re: Parnate Makes Me Tired, posted by bkva23 on January 7, 2016, at 20:58:10
> Parnate def made me weak and sleepy as well.I tried caffiene to no avail,it wasnt to i addd a low dose of pysho stimulant ritalin to te mix that not only did the fatique totaly lift but the parnate worked 10 fold.
That is really interesting. Does the ritalin not affect your sleep? Or maybe you dont have problems with sleep? I find that as well as feeling tired during the day, I also have insomnia and have to take sleep meds . I try to limit them to 3/4 times per week, but that is why I do not drink coffee. Let me know, I find it really interesting that the stimulant makes the parnate work better also.
Posted by bkva23 on January 8, 2016, at 12:30:06
In reply to Re: Parnate Makes Me Tired » bkva23, posted by rose45 on January 8, 2016, at 2:21:27
First let me say i feel for your situtation.When parnate made me sleep it was a night mare.Yess upon getting my doc to agree to the addition of ritalin i noiticed an immediate lift in fatique.I no longer slept and as a MAJOR plus it helped my parnate work so much better i was actualy able to drop the parnate dosage.
As far as insomnia goes,youre not alone one person said it right insomnia is not a side effect of parnate its an EFFECT.Almost everyone deals with it.I have to help myself to sleep i find the combo of gabentin and klonopin the best and even better the doses hang over to the next day so i usualy never find a need for a anti anxiety agen during the day.Plese feel free to ask more questions bless.
Posted by rose45 on January 12, 2016, at 13:39:24
In reply to Re: Parnate Makes Me Tired, posted by bkva23 on January 8, 2016, at 12:30:06
> First let me say i feel for your situtation.When parnate made me sleep it was a night mare.Yess upon getting my doc to agree to the addition of ritalin i noiticed an immediate lift in fatique.I no longer slept and as a MAJOR plus it helped my parnate work so much better i was actualy able to drop the parnate dosage.
>
> As far as insomnia goes,youre not alone one person said it right insomnia is not a side effect of parnate its an EFFECT.Almost everyone deals with it.I have to help myself to sleep i find the combo of gabentin and klonopin the best and even better the doses hang over to the next day so i usualy never find a need for a anti anxiety agen during the day.Plese feel free to ask more questions bless.Have you taken picamilon with parnate ? I have just ordered some, and hope it is safe to use with an maoi? Apparently, it is a weak maoi itself.
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