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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 morganator on August 27, 2009, at 0:21:58
If I take Parnate will it make it harder for me to lay in bed with my eyes closed?? This was hard to do for very long a year ago but I seemed to have reached a point where it is a way of not dealing with reality.
Has anyone heard of using Parnate Nardil to get out of depression for a year and then successfully switching to another AD that was not an MAOI?
Hey Scott, What do you think of the idea of taking Parnate one time in upon waking and Agomelatine one time at night before bed?
Posted by SLS on August 27, 2009, at 7:00:45
In reply to AD that will get me out of bed, posted by morganator on August 27, 2009, at 0:21:58
> Hey Scott, What do you think of the idea of taking Parnate one time in upon waking and Agomelatine one time at night before bed?
I am really hoping that Parnate and agomelatine can be combined. I would like to try that for myself if things don't work out for me with lithium.
I can see how agomelatine might remain effective as a sleep enhancer, but I am not as sure that Parnate will remain effective as a promoter of wakefullness. I should think that the body would build up a tolerance to the amphetamine effect of Parnate. What about using Provigil? I would continue to dose Parnate in a twice a day manner. I still think going 24 hours without Parnate allows for too much MAO recovery. I really don't have a good "feel" for once a day dosing. With me, however, if I miss my afternoon dose, by early evening I can already feel the effects, often falling asleep and having vivid and hypnagogic dreaming, presumably a REM rebound effect. I never tried taking all of my Parnate at once, so I can't really attest to its utility.
- Scott
Posted by Phillipa on August 27, 2009, at 11:34:58
In reply to Re: AD that will get me out of bed » morganator, posted by SLS on August 27, 2009, at 7:00:45
You asked if anyone also had gone from an MAOi back to an ad. Justherself has done that and some other posters on here Maybe they will read your post. Phillipa
Posted by desolationrower on August 27, 2009, at 21:53:45
In reply to Re: AD that will get me out of bed » morganator, posted by SLS on August 27, 2009, at 7:00:45
i think melatonin is metabolised by MAO, so M receptors are saturated anyway during MAOI therapy. the 5ht antagonism might still be helpful
-d/r
Posted by morganator on August 28, 2009, at 1:15:37
In reply to Re: AD that will get me out of bed » morganator, posted by SLS on August 27, 2009, at 7:00:45
Only because I have heard of people having success with treating depression dosing Agomelatine one time at night did I think that it may be enough to help you feel good throughout the day along with the morning boost and late afternoon to evening lag of Parnate.
I wonder why Agomelatine has had success in treating depression with it's short half life and one time dosing at night. Hmmm....
Posted by Sigismund on August 28, 2009, at 2:08:23
In reply to Re: AD that will get me out of bed, posted by morganator on August 28, 2009, at 1:15:37
I read on Wikipedia that agomelatine has a half life of 2 or 3 hours.
This is odd, and does not chime with the feeling of it.
Downstream effects?
Posted by morganator on August 28, 2009, at 5:21:25
In reply to Re: AD that will get me out of bed » morganator, posted by Sigismund on August 28, 2009, at 2:08:23
>Downstream effects?
That's what I'm thinking. The melatonergic properties are enough to give you a good night's sleep and the 5ht2c antagonism is powerful enough to give you the norepinephrine, serotonin, and dopamine boost during the day? Not quite sure what is going on there? I remember some of this being discussed in an earlier thread.
You are taking it currently aren't you?
Posted by Sigismund on August 28, 2009, at 15:39:04
In reply to Re: AD that will get me out of bed » Sigismund, posted by morganator on August 28, 2009, at 5:21:25
Yeah, I take 25 or 37.5.
Posted by linkadge on August 28, 2009, at 20:38:02
In reply to Re: AD that will get me out of bed » morganator, posted by Sigismund on August 28, 2009, at 15:39:04
Short term blockade of receptors may be all thats necessary for adaptive changes in neurotransmitter systems.
Since both 5-ht2c antagonism and agonism apparently have antidepressant effects, perhaps the short term effect of either agent will provide an opportunity for the yang of the system to work more effectively.
Traditional psychiatry has been more concerned with blasting one or two neurotransmitter systems for prolonged periods of time. This may not be what is needed.
Linkadge
Posted by Sigismund on August 28, 2009, at 21:16:14
In reply to Re: AD that will get me out of bed, posted by linkadge on August 28, 2009, at 20:38:02
>Traditional psychiatry has been more concerned with blasting one or two neurotransmitter systems for prolonged periods of time. This may not be what is needed.
Maybe that is why there is not much of a withdrawal syndrome reported?
Posted by uncouth on August 28, 2009, at 21:21:35
In reply to AD that will get me out of bed, posted by morganator on August 27, 2009, at 0:21:58
only thing i have to add is, do not underestimate the adaptive changes that take place when you are on an MAOI for a meaningful amount of time. an MAOI is a huge shock to the system and the brain "grows" around the drug. all of a sudden allowing MAO to come back and do it's job, while thinking that an SNRI will be enough to "pick up the slack" is crazy in my opinion.
I have been on Emsam and Parnate for a total of 9 months. I wasn't doing that great on Parnate, and wanted to switch to Effexor+Adderall. That was the decision that ended up putting me in the hospital, 22 sessions of ECT, and a merrygoround of meds i'm on right now that we still can't get right. Now i'm on Wellbutrin 450. What I should have done is not gone off the parnate, but gone UP, and added Lithium and Abilify.
MAOIs are extremely powerful and effective when dosed correctly but they do cause serious changes to brain physiology.
Posted by desolationrower on August 28, 2009, at 23:13:31
In reply to Re: AD that will get me out of bed, posted by linkadge on August 28, 2009, at 20:38:02
> Short term blockade of receptors may be all thats necessary for adaptive changes in neurotransmitter systems.
>
> Since both 5-ht2c antagonism and agonism apparently have antidepressant effects, perhaps the short term effect of either agent will provide an opportunity for the yang of the system to work more effectively.
>
> Traditional psychiatry has been more concerned with blasting one or two neurotransmitter systems for prolonged periods of time. This may not be what is needed.
>
> Linkadge
>
>
>
>
>
>
>especially if taken at night, since 5ht2c blx causes a large increase in slow wave sleep. that alone could antidepress one.
-d/r
This is the end of the thread.
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