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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Vince on August 23, 2002, at 8:38:52
I started parnate about 2 1/2 weeks ago. I'm taking 30mg. It's seems that my depression is worse. I have very low troughs and I seem to be withdrawing into myself. Does the depression sometimes get worse before it gets better when starting on this drug? I don't know if I should keep going because I can't take it if it gets anyworse. Or should I tell my pdoc that I want to get off and try something else. Neither option sounds fun - drying out for two or three weeks on no medication at all or taking a chance on getting worse on parnate. Please help, anyone who might have experience.
Vince
Posted by cybercafe on August 23, 2002, at 12:11:21
In reply to Parnate - help, not doing so well, posted by Vince on August 23, 2002, at 8:38:52
> I started parnate about 2 1/2 weeks ago. I'm taking 30mg. It's seems that my depression is worse. I have very low troughs and I seem to be withdrawing into myself. Does the depression sometimes get worse before it gets better when starting on this drug? I don't know if I should
yeah i found my depression got worse as well.. i think it's because MAOIs have different mechanisms than SSRIs, so switching from one SSRI to another will include less starting-overness than switching from an uptake inhibitor to an MAO inhibitor ....
... what eventually happened for me was i found my anxiety went away and also i started to enjoy being around my friends more (they used to bore me) ... so i started doing more social things... while my depression was still bad when not socializing.... and then my depression started to really lift... but i am sure if i had stayed in my basement my recovery would have been a bit slower
i would give it a lot longer than 2 and a half weeks.. really that's nothing.. especially since the stimulant effect will probably wear off before the antidepressant effect fully kicks in
Posted by sjb on August 23, 2002, at 13:40:47
In reply to Re: Parnate - help, not doing so well, posted by cybercafe on August 23, 2002, at 12:11:21
I'm not sure if I would agree that Vince should keep at Parnate for "a lot longer." I read somewhere that if you don't respond postively to an MAOI in 3 weeks, you probably won't ever. Most of us waste so much time waiting for drugs to work, changing meds, titrating or washing-out, why prolong what is not working? Obviously, Vince's PDoc knows best (hopefully), but I personally don't think he should stick with it much longer.
Of course, I am biased. I tried Parnate last year and did not like it at all. I had TOTAL insomnia for the first 3 days and had difficulity sleeping at night after that. Of course, I started to fall asleep in my office at about 3-4pm everyday. Embarrassing to have your head snap up due to drool running down your chin in your own office!
Anyway, I also had difficulity working out and my reaction time seemed much decreased. Driving was scary. My 2c. I had a theory that MAOI's work better for men than women based on what I've read on this board. Obviously, an exception here, but it's seemed to me that the folks that have had the most sucess with MAOIs have, for the most part, been male.
Posted by cybercafe on August 23, 2002, at 15:02:22
In reply to Re: Parnate - help, not doing so well, posted by sjb on August 23, 2002, at 13:40:47
> I'm not sure if I would agree that Vince should keep at Parnate for "a lot longer." I read
i don't think it's reasonable to expect an antidepressant to work in 2 weeks, that's all
>somewhere that if you don't respond postively to an MAOI in 3 weeks, you probably won't ever.
hmm.... i would be interested to know where you read that ...
i know i didn't start getting the major antidepressant effect till about 2 months... i think jess took sometime too, but i'm not sure ... i remember someone saying that it wasn't until the 3rd month on nardil that social anxiety was cured .. and it was like a switch...i know i'm glad i stuck with it... i thought it was horrible at first...
>Most of us waste so much time waiting for drugs to work, changing meds, titrating or washing-out, why prolong what is not working? Obviously,
you're right... i think it's absolutely horrible to have to spend so long waiting for a decent effect.. now you should be able to notice a diff in 4 weeks, in general.. however i believe that applies to going from no drugs to taking your first med... i think if you go off a drug which is giving you a partial response then you are going to lose that partial response and feel like you are getting worse no?
>Vince's PDoc knows best (hopefully), but I personally don't think he should stick with it much longer.
how long would you recommend?
> Of course, I am biased. I tried Parnate last year and did not like it at all. I had TOTAL insomnia for the first 3 days and had difficulity sleeping at night after that. Of course, I started to fall asleep in my office at about 3-4pm everyday. Embarrassing to have your head snap up due to drool running down your chin in your own office!parnate kept me up at night, but it was a welcome change from over sleeping... i just took gabapentin before i went to bed and was okay... others take trazodone or whatever..
i find depression hard to get rid of, but insomnia easy to get rid of... so i choose to get rid of the depression first, then worry about other stuff
and i can totally relate to falling asleep at work from the other meds i used to take before parnate... depakote + klonopin + effexor + inderol + gabapentin ... sometimes you bang your arm or head on the keyboard/desk and you look around wondering who noticed ... Ug ...
> Anyway, I also had difficulity working out and my reaction time seemed much decreased. Driving was scary. My 2c. I had a theory that MAOI'sreally? .. i didn't experience reaction time problems on parnate... i did have hypotension for the first little while, but it went away quite quickly ...
>work better for men than women based on what I've read on this board. Obviously, an exception here, but it's seemed to me that the folks that have had the most sucess with MAOIs have, for the most part, been male.i dunno... i think jess seemed to like parnate ...
Posted by utopizen on August 25, 2002, at 0:16:28
In reply to Re: Parnate - help, not doing so well, posted by cybercafe on August 23, 2002, at 15:02:22
cyber,
I'm curious to know your particuliar change in social anxiety symptoms while on it- I also relate to feeling bored around my friends... a lot. People in general bore me at the moment.
But how do you fare on public speaking with the stuff? Do you still need to mix anxiety cocktails, like add klonopin or gabetin?
I'm tempting to ask (read: beg, since I sort of asked two months ago) my doctor to get on this, but seriously doubt I could convince him that it could work in 3 months... he's not so patient even with my ssri's.
Posted by cybercafe on August 25, 2002, at 1:06:27
In reply to Re: Parnatecybercafe, posted by utopizen on August 25, 2002, at 0:16:28
> I'm curious to know your particuliar change in social anxiety symptoms while on it- I also relate to feeling bored around my friends... a lot. People in general bore me at the moment.
hmm! .... i used to be really really bad...
like i would feel deep inner turmoil if i was being instructed and couldn't follow instructions absolutely perfectly ... ummm... i guess i would be worried that people are looking at me or judging me ... it's hard for me to even imagine wasting my time with such thoughts now...
however when it comes to agoraphobia like sitting in a movie theatre for hours or in a car... or approaching cute women i'd probably go for some gabapentin .. though i'm on the lowest dose and am just starting to see my depression lift ...
though i think inability to sit still might be more agitation than anxiety in my case... like i notice all of my friends can just sit still whereas i am always moving about... i am hoping this will disappear when the depression goes into 100% remission .. and things become more interesting...> But how do you fare on public speaking with the stuff? Do you still need to mix anxiety cocktails, like add klonopin or gabetin?
public speaking? like a speech? ... don't know how i'd do on a speech, but i can speak loudly and unapologetically to groups of people without getting that fear/sadness response if suspect they are displeased...
i mean i am more interested in doing stuff i like then pleasing the people around me now...... i take gabapentin sometimes because i want to be able to sit still -- i don't think this was caused by parnate itself... also if i am going to be talking to cute girls or groups of strangers (i love socializing what can i say??)
> I'm tempting to ask (read: beg, since I sort of asked two months ago) my doctor to get on this, but seriously doubt I could convince him that it could work in 3 months... he's not so patient even with my ssri's.
why beg? .. just print out some studies.... lots of studies... do you live near a university? med school? psychiatric facility with a library? hospital?
Posted by utopizen on August 25, 2002, at 11:55:28
In reply to Re: Parnatecybercafe, posted by cybercafe on August 25, 2002, at 1:06:27
lol- I live in Boston, med schools shouldn't be hard to find...
=)
But it looks like my doc will warm up to stuff now. He tries to get the possibles ot of the way, the srris and stuff, then he'll give me like 15mg of klonopin for 2 months, it's like weaning prescription scripts out of an elderly cow. eventually, I should get it, since we''re both agreeing now i'm treatment resistant. I'll see him in a few days.
Lots of neuroimaging research nearby at Harvard- that's the big trend. I'd like t o see if my PPO covers that. Otherwise, I get it free anyway in a few weeks for a one-day ADD study. Also want to see if by chance my PPO covers Oldanestrom (sp).
As for exotic and trendy selective MAOIs, I don't think I'm so desperate I have to pay Canada hundreds of dollars for non-insured pills. I'd prefer to take a bit longer testing out stuff I know my insurance will always pay for. And Neurontin's great, and so is my "emergency" supply of Klonopin in case I ever need to use it.
I would suggest to you asking for a short supply of Klono if you haven't already, it's good for when you don't have three hours to pace around in empty hallways while you wait for N-star to do its trick. But I think I'm giving up on the stuff, it just makes me so chill, yet so untalkative, it's totally pointless for my condition.
Posted by Lucy Nash on August 25, 2002, at 18:48:07
In reply to Re: Parnate - help, not doing so well, posted by sjb on August 23, 2002, at 13:40:47
> Anyway, I also had difficulity working out and my reaction time seemed much decreased. Driving was scary. My 2c. I had a theory that MAOI's work better for men than women based on what I've read on this board. Obviously, an exception here, but it's seemed to me that the folks that have had the most sucess with MAOIs have, for the most part, been male.
>Don't mean to be devil's advocate but MAOIs have always been the only med that helped my long-term, atypical depression (which included a lot of social phobia/agoraphobia). Marplan was the best, but I had to switch to Nardil when Roche stopped manufacturing it. Nardil's almost as good as Marplan as far as effectiveness goes - I'm really productive in the mornings, after my first breakfast-time dose (which is the largest; I take a third one around 5pm). But I've a lot of problems controlling my weight gains with it.
As mentioned before, I'd like to switch back to Marplan so I'll stop ballooning into middle age, but I really can't handle the thought of a total MAOI/Nardil washout.
Posted by cybercafe on August 26, 2002, at 2:07:50
In reply to Re: Parnatecybercafe, posted by utopizen on August 25, 2002, at 11:55:28
> But it looks like my doc will warm up to stuff now. He tries to get the possibles ot of the way, the srris and stuff, then he'll give me like 15mg
hmmm! .. i suspect the appropriate treatment for a noncompliant doc is a printout of the APA practice guidelines for ___ disorder + a degree of respect and politeness
> Lots of neuroimaging research nearby at Harvard- that's the big trend. I'd like t o see if my PPO covers that. Otherwise, I get it free anyway in a few weeks for a one-day ADD study. Also want to see if by chance my PPO covers Oldanestrom (sp).
i keep hearing about how hard it is to get imaging ... then i find out one of my mates had a knee problem diagnosed correctly by a doc, but wanted to get an MRI done (for free, covered by gov't) .. waited 3 weeks, and found out the doc was (obviously) correct! .... whereas those of us who are in so much agony 10% die from suicide, ... well i don't know how the medical establishment would respond ... but i would be upset if i were denied, that's for damn sure
> As for exotic and trendy selective MAOIs, I don't think I'm so desperate I have to pay Canada hundreds of dollars for non-insured pills. I'dhey with our dollar, hundreds of canadian dollars = a couple dollars, american
> I would suggest to you asking for a short supply of Klono if you haven't already, it's good for when you don't have three hours to pace around in empty hallways while you wait for N-hey i have an anxiety disorder... don't you know that all people with anxiety disorders have a secret stash of 3 or 4 months supply built up? :) :)
though i havn't ever had to use it.... i think taking the neurontin gives me a placebo effect... knowing that, minute by minute, i am only going to feel better.... but then again, my anxiety problems are pretty much just sitting still (more agitation) ...
>star to do its trick. But I think I'm giving up on the stuff, it just makes me so chill, yet so untalkative, it's totally pointless for my condition.
i am worried about benzos causing depression
i am not allowed in clubs because the bouncer thinks i am drunk (after a 2 hour journey there!)
my friends don't want to be around me cuz i don't seem all there
benzos make me sleepy ...
cause a drunken stupor
people on the street ask me what i'm on!
i have to worry about .. is the AD not working or is the klon impeding it
i want to be mr. athletic, and i worry that it's affecting my strength
i worry about addiction
i worry about effects on memorybasically, i'm a neurontin man now!
and everybody loves me!
Posted by sjb on August 26, 2002, at 9:15:19
In reply to Re: Parnate - help, not doing so well, posted by cybercafe on August 23, 2002, at 15:02:22
You raise some good questions and objections. We all can react so differently to the same meds. I would clarify, however, that I meant MAOI's, spec. Parnate, when I was referring the the 3 weeks. I believe SSRIs can take longer. I read this from a site out of Cananda and it could've been totally bogus, I don't know. However, my PDoc tended to back it up, and after I was showing no improvement in 3 weeks, he thought decided it wasn't a good drug for me.
Posted by Vince on August 26, 2002, at 14:56:57
In reply to Re: Parnate - help, not doing so well, posted by cybercafe on August 23, 2002, at 12:11:21
Thanks - your post helped me get through the weekend.
I Called my pdoc Friday morning before he left town and he told me to lower the dose to 20mg over the weekend and see how I felt Monday. I feel much better. Sunday was a much better day. I think I will start to increase the dose again.
I think Parnate stirred the amino caldrin causing some termoil - maybe that's a sign.
Vince
> > I started parnate about 2 1/2 weeks ago. I'm taking 30mg. It's seems that my depression is worse. I have very low troughs and I seem to be withdrawing into myself. Does the depression sometimes get worse before it gets better when starting on this drug? I don't know if I should
>
> yeah i found my depression got worse as well.. i think it's because MAOIs have different mechanisms than SSRIs, so switching from one SSRI to another will include less starting-overness than switching from an uptake inhibitor to an MAO inhibitor ....
>
> ... what eventually happened for me was i found my anxiety went away and also i started to enjoy being around my friends more (they used to bore me) ... so i started doing more social things... while my depression was still bad when not socializing.... and then my depression started to really lift... but i am sure if i had stayed in my basement my recovery would have been a bit slower
>
> i would give it a lot longer than 2 and a half weeks.. really that's nothing.. especially since the stimulant effect will probably wear off before the antidepressant effect fully kicks in
>
>
This is the end of the thread.
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