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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 Jimmyboy on January 12, 2007, at 11:15:13
Hi all,
I am fed up, its been 8 months of severe depression, tons of medications and still no relief whatsoever.. so I am seriously thinking about a MAOI, because many people seem to find relief from those when nothing else works. .
I was thinking about Parnate, due to its stimulating effects ( which I desperately need) .
Some questions :
1. I am currently taking Serzone, how long do I have to go between stopping Serzone and starting Parnate?2. What is the starting dose, what is a good schedule of how to raise the dosage.
3. How long for it to start working?
4. How bad are sexual side effects, compared with SSRI's?
Any other things people want to say about, I would love to hear, the more the better.
thanks
JB
Posted by Quintal on January 12, 2007, at 14:03:47
In reply to People who know about Parnate - talk to me.., posted by Jimmyboy on January 12, 2007, at 11:15:13
>1. I am currently taking Serzone, how long do I have to go between stopping Serzone and starting Parnate?
Official advice is to wait one week between stopping Serzone and starting Parnate.
>2. What is the starting dose, what is a good schedule of how to raise the dosage.
The starting dose is usually 20mg; one in the morning and one in the afternoon, 3:00PM at the latest. The dose is then usually raised to 30mg (10mg in the morning and 20mg in the afternoon [though some recommend the reverse if insomnia is a problem]) if no response after two weeks.
>3. How long for it to start working?
Similar to other AD's up to a month, but the stimulant effects may appear straight away. I felt the antidepressant effect in the first week.
>4. How bad are sexual side effects, compared with SSRI's?
Parnate rarely causes severe sexual side effects. Many people (myself included) find it has a mild aphrodisiac effect at first. Ejaculation might be slightly delayed if you have sex before the stimulant effect of the last dose wears off but the sex is still pleasurable unlike the SSRI numbness.
I like Parnate. I felt euphoric when I raised the dose to the 80-120mg range, but I was also taking it with ~4mg Klonopin which might have helped smooth the jitters. Low doses (20-30mg) made me feel more anxious and depressed. I recommend you give Parnate a try so long as you have access to benzos or other sleeping tablets in case you need them (you probably will). I found that when the stimulant effect of Parnate wore off the sedative effect of the Klonopin took over and I fell into a deep sleep but I needed to take another 10mg dose in the afternoon (about 5:00PM) to avoid the notorious afternoon slump and keep me going until bedtime.
Q
Posted by Jimmyboy on January 12, 2007, at 15:09:05
In reply to Re: People who know about Parnate - talk to me.. » Jimmyboy, posted by Quintal on January 12, 2007, at 14:03:47
Hey Q,
Thanks for the info .. I do have access to benzo's, but I can barely stay awake all day long (almost to the point of narcolepsy) I would be very surprised if it kept me up.. actually that would be a welcome side effect for me!
1. Can I take this with a low dose of Lithium , or would that be counterproductive?
2. What about exercise? Does this cause blood pressure probs so I can not exercise ( or actually start exercising : )3. Had you tried a lot of other drugs before this? ( I heard thi sone works where others, SSRI's , TCA's fail)
4. Does it help with motivation ? Also motivation for social interaction ? --for many many months I just don't care to make the effort..5. Also, you said the official washout is 7 days.. what about unoffcial? :) I am on a small dose of Serzone, and serzone is so weak on serotonin anyway, just wondering.
Thanks alot,
JB
Posted by Quintal on January 12, 2007, at 16:59:20
In reply to Re: People who know about Parnate - talk to me.., posted by Jimmyboy on January 12, 2007, at 15:09:05
>Thanks for the info .. I do have access to benzo's, but I can barely stay awake all day long (almost to the point of narcolepsy) I would be very surprised if it kept me up.. actually that would be a welcome side effect for me!
Well Parnate should help with that in the 80-120mg range :-) The Serzone may be making you feel more tired than you realize though.
>1. Can I take this with a low dose of Lithium , or would that be counterproductive?
Yes, it's safe to combine them. Lithium can augment the antidepressant effect of Parnate.
>2. What about exercise? Does this cause blood pressure probs so I can not exercise ( or actually start exercising : )
Blood pressure changes are common at the beginning of MAOI treatment, but your body should adjust in a few weeks. Parnate should not limit your ability to exercise - I started working as a temporary garbage man walking up to 8 miles a day just a few weeks after starting Parnate and had no problems. I think the Parnate actually helped me stay motivated and alert.
>3. Had you tried a lot of other drugs before this? ( I heard thi sone works where others, SSRI's , TCA's fail)
Yes, I've tried nearly all of them bar Nardil. Here's list of treatments I tried that I posted earlier: http://www.dr-bob.org/babble/20061217/msgs/715059.html
>4. Does it help with motivation ? Also motivation for social interaction ? --for many many months I just don't care to make the effort..
Yes, it helped keep me motivated at high doses. I'm not sure it helped much with social interaction but I have severe social anxiety probably due to some autistic spectrum traits (Asperger's Syndrome) so that may not apply to you. I think Parnate would probably make you feel more comfortable around people if the reason your finding it so difficult now is mainly down to depression and apathy.
>5. Also, you said the official washout is 7 days.. what about unoffcial? :) I am on a small dose of Serzone, and serzone is so weak on serotonin anyway, just wondering.
I dare say it's been done somewhere but I wouldn't try it personally. Parnate isn't very forgiving of mistakes with serotonergic meds and you don't want to be rushed to the ER with serotonin syndrome on your first trial of an MAOI and jeopardise your chances of a pdoc prescribing them again in the future.
I ran the Parnate+Serzone combo through this interaction checker and it says: "This interaction is well-documented and is considered major in severity."
Q
Posted by halcyondaze on January 12, 2007, at 18:30:11
In reply to People who know about Parnate - talk to me.., posted by Jimmyboy on January 12, 2007, at 11:15:13
I was on Parnate for six months last year and have been on it again for three months now.
>
> Some questions :
>
>
> 1. I am currently taking Serzone, how long do I have to go between stopping Serzone and starting Parnate?I believe it's a 2 week washout for Serzone.
>
> 2. What is the starting dose, what is a good schedule of how to raise the dosage.I was started on 30 mg (1 tab TID). A couple of weeks later, I was increased to 40. A couple of weeks after that, 60, then 80, then 100, then 120, then 130.
This time I have managed to stay around 60 mg to minimize side effects.
>
> 3. How long for it to start working?For me, within a few days. It is a very stimulating medication; however, the activating effects occur before the antidepressant effect does, so once you become used to the dose, you have to evaluate your depression.
>
> 4. How bad are sexual side effects, compared with SSRI's?Not nearly as bad as SSRIs. I do have delayed orgasm but at least I can have them! Plus, NOT that I recommend this, but if I go one day without taking it and I become hypersexual.
>
> Any other things people want to say about, I would love to hear, the more the better.
>
> thanks
>
> JB
Posted by halcyondaze on January 12, 2007, at 18:37:06
In reply to Re: People who know about Parnate - talk to me.., posted by Jimmyboy on January 12, 2007, at 15:09:05
1. Can I take this with a low dose of Lithium , or would that be counterproductive?
If the Lithium is helping you, perhaps you should stay with what works. It might also prevent agitation from Parnate.
>
>
> 2. What about exercise? Does this cause blood pressure probs so I can not exercise ( or actually start exercising : )I've had no problem with this.
>
> 3. Had you tried a lot of other drugs before this? ( I heard thi sone works where others, SSRI's , TCA's fail)Before Parnate, I was on: Zoloft, Prozac, Celexa, Lexapro, Effexor XR, Cymbalta, Clomipramine, Desipramine, Nortriptyline, Trileptal, Topamax, Zonegran, Lamictal, Seroquel, Risperdal, Zyprexa, Wellbutrin, and BuSpar. I tried EMSAM briefly after my first go round with Parnate but it didn't work. The only meds that have worked for me are Parnate and Zoloft (and, for sleep, Seroquel).
>
>
> 4. Does it help with motivation ? Also motivation for social interaction ? --for many many months I just don't care to make the effort..Absolutely. It is quite amphetamine-like.
>
> 5. Also, you said the official washout is 7 days.. what about unoffcial? :) I am on a small dose of Serzone, and serzone is so weak on serotonin anyway, just wondering.Talk to your doctor. Seriously.
>
> Thanks alot,
>
> JB
>
>
This is the end of the thread.
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