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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by shelliR on August 14, 2001, at 17:12:28
on it, stuck to it and had a successful ending. It's been a week, I can't get higher than 10mg without feeling very tired and very sick in my stomach. I am not very optimistic. With Nardil, I didn't have any positive effects for a while, but none of this sickness and tiredness. Really no drugs that have ever worked for me has started poorly like this. I'm ready to throw in the towel, unless there is anyone out there who has a sick rocky start with parnate, but it turned out to be the right AD for them.
Any feedback would be appreciated, good or bad, so I can make a decision. Pdoc is away until next week.
Shelli
Posted by may_b on August 15, 2001, at 13:36:08
In reply to PARNATE, has anyone who had a horrible start, posted by shelliR on August 14, 2001, at 17:12:28
Hi ShelliR
Here's my 2 cents, even though I don't meet your criteria very well, i.e.:
> on it, stuck to it and had a successful ending.
> It's been a week, I can't get higher than 10mg without feeling very tired and very sick in my stomach.
My first week was odd. Start day was great, like a caffeine buzz all day. Couldn't sleep. As the week wore on I got tired-er and tired-er. Sleep was a real scarcity. This I think caused some focus problems. But I noticed that my mood was brighter, I was more noise tolerant, and could handle my family easily. < g > However, I'm the one who had one local, bottled beer and the hypertensive crisis. Stopped Parnate afterward.
The good thing I can say about Parnate it that it bumped me out of the sad horrors. Am coasting for now. If the Beast (depression) returns, I am planning to go back on Parnate, with an emerg anti hypertensive in my possession (Captopril).
Sure hope it works for you. But I sure know about insufferable side effects, and trying to work while acclimatizing to a new AD.
Best wishes,
may_b
Posted by SLS on August 15, 2001, at 14:00:48
In reply to PARNATE, has anyone who had a horrible start, posted by shelliR on August 14, 2001, at 17:12:28
Interaction with oxycodone?
Good luck. :-)
- Scott
Posted by shelliR on August 15, 2001, at 14:52:15
In reply to Re: PARNATE, has anyone who had a horrible start, posted by SLS on August 15, 2001, at 14:00:48
> Interaction with oxycodone?
>
> Good luck. :-)
>
>
> - ScottNo, interaction; at least both are prescribed by the same pdoc. But I've decided to stop the parnate. I can't stand the tiredness and sickness, and I can't work when I feel that sick. I don't know how people do drug trials and continue working.
I'm thinking of going back to nardil, my old buddy, and trying either concerta or buprenorphine with it, depending on what my pdoc thinks about the bup. Last time, he felt I may as well stay on the oxycontin, but I have had to go up on the oxy, so I don't know. And oxy and concerta are not good for me together, too stimulating. Anyway..........
YOU'RE BACK. How are you? Why away for so long? Did you move? Meds any better?
Share, please. Shelli
Posted by shelliR on August 15, 2001, at 15:06:31
In reply to Re: PARNATE, has anyone who had a horrible start, posted by may_b on August 15, 2001, at 13:36:08
> Hi ShelliR
>
> Here's my 2 cents, even though I don't meet your criteria very well, i.e.:
>
> > on it, stuck to it and had a successful ending.
>
> > It's been a week, I can't get higher than 10mg without feeling very tired and very sick in my stomach.
>
> My first week was odd. Start day was great, like a caffeine buzz all day. Couldn't sleep. As the week wore on I got tired-er and tired-er. Sleep was a real scarcity. This I think caused some focus problems. But I noticed that my mood was brighter, I was more noise tolerant, and could handle my family easily. < g > However, I'm the one who had one local, bottled beer and the hypertensive crisis. Stopped Parnate afterward.
>
> The good thing I can say about Parnate it that it bumped me out of the sad horrors. Am coasting for now. If the Beast (depression) returns, I am planning to go back on Parnate, with an emerg anti hypertensive in my possession (Captopril).
>
> Sure hope it works for you. But I sure know about insufferable side effects, and trying to work while acclimatizing to a new AD.
>
> Best wishes,
>
> may_b
Hi May.In my searches last night to try to decide whether to continue parnate, or drop it (I decided to drop it), I searched parnate from back through 1998 on the PB search. I was looking for bad start, good finish, but in the process I came upon at least one person, maybe two, who had had spontaneous hypertensive crises, non-food related, after just starting parnate. So that is what may have happened to you. I had never heard of that before, but there may be more info on the internet about it.
I know it must have been an awful experience, but the good side is that very quickly you found out that parnate may be the right AD for you. (considered in some circles to be quick a miracle), if you can be ready for a hypertensive crisis and if the sleepiness goes away. I got one yes and one no re the sleepiness. I think if I had any sign that parnate made me feel less depressed, I would have stuck in there a little longer, but it just didn't add up to a good equation for me: no lessening of depression; intolerable side effects.
Thanks for writing, Shelli
Posted by SLS on August 18, 2001, at 8:50:10
In reply to Re: PARNATE, has anyone who had a horrible start » SLS, posted by shelliR on August 15, 2001, at 14:52:15
> YOU'RE BACK. How are you? Why away for so long? Did you move? Meds any better?
Hi ShelliR.
Well, I wouldn't exactly say that I'm back. Things have pretty much sucked for the last few months. I haven't been feeling well enough to post. Fortunately, things didn't deteriorate until after I moved into my new apartment. I've been here for over two months and still have a bunch of stuff to unpack. I'm real happy with the place, though.
A few months ago, I added Effexor to the Lamictal 300mg and nortriptyline 100mg that I had been taking. At first, I experienced some encouraging hints of improvement at 150mg/day. However, I quickly deteriorated and became as severely depressed as I have been in a long time. Basically motionless. I thought perhaps that the Effexor was reducing the clearance of nortriptyline (CYP450 2D6 ?) and thereby raising blood-levels beyond my therapeutic window. Whatever - lowering the dosage of nortriptyline helped. However, my doctor was reluctant to prescribe more than 25mg/day. After trying a dosage of Effexor of 450mg for a month, I have reduced it down to 300mg. My doctor feels that this is the minimum dosage at which the full range of its benefits can be adequately tested. I am now in the process of increasing the dosage of nortriptyline to see what I can squeeze out of it. My main complaints regarding Effexor are that it has generally reduced drive, motivation, and libido. It seems to have also produced a bit of "brain fog", and has left me feeling pretty stupid - more stupid than usual.
I am trying to fight the temptation to switch over to Nardil immediately. Logically, I guess it makes sense to continue playing with augmentation strategies. I should at least finish exploring the optimization of nortriptyline dosing. Nortriptyline is truly a pain in the ass for me. It really does have a finicky window. I sometimes feel like I should just dump it and gorge myself on imipramine, a drug that seems to help me as much as nortriptyline, but is without a window. The only thing is that the anticholinergic side effects of imipramine make it more difficult to add Nardil to. Hypotension , constipation, and urinary retention are of most concern. Imipramine also produces more cognitive side effects (memory difficulties and dull-wittedness) and weight-gain. If it were to work, though, the restoration of the cognition stolen by depression would more than offset any negative effects produced by the drug. We'll see. I'll probably at least try adding Geodon or Zyprexa to Effexor before making the switch.
I understand that you are interested in trying Nardil again. I would like to mention that, for me, the addition of desipramine to Nardil not only produced a better antidepressant effect, but also seemed to prevent the weight-gain that I had previously experienced with Nardil.
Thanks for your kind concern.
- Scott
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