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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by yesac on August 2, 2003, at 17:54:29
I saw my doc last Monday. My regimen was Parnate 60mg, to which I didn't feel I was getting any response, and Lamictal 150mg, which I also didn't feel I was getting a response. He suggested going off of Lamictal. I said I wanted to up the dose and try it for a bit longer. Same with Parnate, as I've been on it only 2 months. I wanted to go up on Parnate, but he said 60 is the maximum dose. I also started taking Neurontin 600mg.
Anyways - the issue is that I have seen that many people go much higher on Parnate than 60. So, I've decided I'm just going to do it. My plan is to go up to 90mg. I also want to go higher on Neurontin. Up to 900mg or even more. I just want to feel some effects from something!!
I also want to go on a stimulant, but he said I can't with an MAOI. I know that's what all the warnings say, but it seems like people here have done it and it's been okay.
In any case - do you think it's bad to just do these things without my doctor's "approval"? I don't think he'd be mad at me exactly, but I just want to keep the trust and openness of the relationship. I don't want him to start thinking he can't trust me.
Posted by cyclistguy on August 2, 2003, at 20:32:19
In reply to is this Bad?, posted by yesac on August 2, 2003, at 17:54:29
using like any other drugs with MAOI's from what I have heard is bad.... but advice is to find a non MAOI to use so you can fiddle around with your percriptions to find out what works for you.
payce,
stay safe.
Posted by EERRIICC on August 2, 2003, at 22:39:53
In reply to is this Bad?, posted by yesac on August 2, 2003, at 17:54:29
Do not add a stimulant to Parnate, I had a horrible hypertensive reaction when I added Adderall. Nothing else, no cheese or other food, caused me to have such a reaction.
Raising Parnate dose to 120mg made a huge difference for me. There is a published study on high dose Parnate on Dr.Ivan's "Depression Central" board. Be careful of becoming "too stimulated" however!
Posted by BekkaH on August 2, 2003, at 23:00:18
In reply to is this Bad?, posted by yesac on August 2, 2003, at 17:54:29
I don't think this is really an issue of being "bad" or "good." And it doesn't have anything to do with your doctor's "approval;" however, you should not add anything to an MAOI without your doctor's guidance and supervision. Yes, sometimes stimulants can be added to an MAOI, but the stimulant has to be introduced carefully and monitored carefully. Your medical history needs to be taken into account. Don't do this on your own. If your current doctor won't prescribe this combination, then perhaps you can go for a second opinion, but don't try the combination on your own.
Posted by HenryO on August 3, 2003, at 1:20:10
In reply to is this Bad?, posted by yesac on August 2, 2003, at 17:54:29
Like a mathematical equation you may want to change only one varieable at a time. If you get some unexpected reaction good or bad you won't know which med caused it if you're tinkering with more than one at the same time.
Posted by yesac on August 3, 2003, at 15:23:45
In reply to Re: is this Bad?, posted by HenryO on August 3, 2003, at 1:20:10
> Like a mathematical equation you may want to change only one varieable at a time. If you get some unexpected reaction good or bad you won't know which med caused it if you're tinkering with more than one at the same time.
I know... you're right... I've never done anything like this before, but I just want SOMETHING to work, to have some effect (I'd prefer good rather than bad though!). I'm desperate.
Posted by Henryo on August 3, 2003, at 20:42:58
In reply to Re: is this Bad? » HenryO, posted by yesac on August 3, 2003, at 15:23:45
If it were me, I'd increase the Lamictal. It just so happens I am doing that now.
Posted by maryhelen on August 5, 2003, at 22:56:56
In reply to is this Bad?, posted by yesac on August 2, 2003, at 17:54:29
Your doc is incorrect. The maximum does of Parnate is not 60 mg. I have been up to 90 mg. and know of others who have gone to 130 mg. with a great response.
My pdoc is very receptive to me presenting information to him off the internet, especially from psycho-babble. He feels that it is the patient who knows the effect of the meds, where as he would have a more clinical view from the literature he has. He certainly does not just give me what I ask for, but I will print out as much information as I gather, and he will be open enough to take it into consideration, get second opinions and usualy allow the trial. He has not refused yet. However, he knows that 90 mg. is an appropriate dose for Parnate.
Just a suggestion.
Some doctors are offended, but if they are professional enough, they will look into the research, or get opinions from other pdocs.
By the way, you refer to my doc. Is this a family doctor or a psychiatrist?
maryhelen
Posted by yesac on August 6, 2003, at 11:02:33
In reply to Re: is this Bad?, posted by maryhelen on August 5, 2003, at 22:56:56
Oh, when I refer to my doctor, I do mean psychiatrist - for some reason I just really don't like the expression "pdoc". I don't know why.
Anyways, thanks for the suggestion. I think he's pretty open to ideas that I have, but I've never just gone ahead and did something that he told me not to do. It wasn't as if he was like "Do NOT go over 60mg", but he just said that 60 was the maximum so I shouldn't go above that.
Maybe I'll print out that article about using high doses of MAOIs for non-responders. The question I have about that is, did they respond at all to lower doses? Because so far I haven't had any response. So could going up cause a response?
Well, thanks again!
Posted by maryhelen on August 6, 2003, at 16:23:25
In reply to Re: is this Bad? » maryhelen, posted by yesac on August 6, 2003, at 11:02:33
Yes, I believe going up to a higher dose with Parnate may give you a response. It did for me. I have also heard 30 mg. being enough for some people. As it is said so many, many, times everyone is different.
I believe in giving each med a fair trial unless you get to a point where you cannot stand the side effects. If you are having no adverse side effects, and do not mind the restrictions, I would go up to a higher dose. Of course you would need your doctor's approval because he would wonder why you would need refills if you go from 60 mg. to 90 mg. on your own. I must be honest in telling you that I upped my Parnate from 80 mg. to 90 mg. on my own, but my pdoc did not seem to notice as I do not see him very often.
He does know I am on 90 mg. but he did not question it.Good luck. Finding the right med and dose is so very frustrating.
maryhelen
This is the end of the thread.
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