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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by kagome on February 22, 2012, at 15:59:27
Hi, I'm new here, but I've followed a lot of the threads. I was hoping that I could get some of the impressive expertise Ive been reading in regards to my situation. I just titrated up to 30mg Parnate, and the exhaustion is driving me crazy. What's strange is that I'll have an elevated heart rate and mentally feel anxious and irritable after taking it, but body-wise I feel extremely heavy and like everything takes too much effort. Even with the racing heart I'm taking a two-hour nap during the day and sleeping all night. I tried messing around with timing - like taking at 6pm, 9pm and midnight but same result. I'm also taking Wellbutrin, which should help with fatigue, but only seems to make the irritability worse.
I just got off Lamictal two weeks ago on a dentist's recommendation, and started Parnate last week. I know I'm just in that miserable stage when you're dealing with the side effects of a medication and not getting the benefits and I should just be patient, but I'm feeling a little desperate. The exhaustion and irritation are terrible for me in terms of suicidal ideation. Does anyone have any advice/ideas/words of wisdom?
Sorry for the long post, thanks for reading!
Posted by SLS on February 28, 2012, at 20:43:30
In reply to More Parnate Questions, posted by kagome on February 22, 2012, at 15:59:27
Hi.
> Does anyone have any advice/ideas/words of wisdom?
Don't rely on dentists to design psychopharmacological treatments for you.
I would consider restarting the Lamictal. Why did you stop taking it in the first place? What was your dosage?
> Sorry for the long post, thanks for reading!
Sorry that no one had replied.
Parnate usuallly doesn't produce a stable antidepressant response until a minimum dosage of 40 mg is reached. I don't feel better until I reach 80 mg.
Wellbutrin? Why? If it isn't helping, maybe it's hurting.
- Scott
Posted by kagome on February 29, 2012, at 0:52:21
In reply to Re: More Parnate Questions » kagome, posted by SLS on February 28, 2012, at 20:43:30
Thanks, Scott, I figured no one replied cause I'm the weirdo that accidentally posted almost the exact same question again when I thought this one hadn't gone through.
Anyway, I took your advice from the other post and stopped taking Wellbutrin. It hasn't made anything worse and I think the anxiety is a little better, so that's good. Now just the crippling, suicidal depression...
Oh, and the dentist had a point - after two years on Lamictal, my teeth went from being pretty darn good to literally falling out of my mouth. Some google checks have found that this isn't too uncommon. Add the cognitive issues and the fact that I never got to total depression remission and it seemed time to stop, although now I totally miss the low level but relatively high functioning dysphoria I experienced on it...
Posted by SLS on February 29, 2012, at 5:58:00
In reply to Re: More Parnate Questions, posted by kagome on February 29, 2012, at 0:52:21
> Oh, and the dentist had a point - after two years on Lamictal, my teeth went from being pretty darn good to literally falling out of my mouth.
Oh my gosh. I didn't know. I'm sorry to hear that.
Please continue to post. I am very interested to see you get better. You have a few options to choose from to augment Parnate in case you don't respond well to it. The first thing is to see how well you tolerate a dosage of Parnate between 40 - 80 mg. If this is your first time on Parnate, you might find that dizziness becomes a limiting factor to rapid dosage escalation. This seems to get better with time, though.
One step at a time.
I am currently taking:Parnate 80 mg
nortriptyline 150 mg
Lamictal 200 mg
Abilify 10 mg
lithium 300 mg
prazosin 6 mgI am responding to this treatment. If I attempt to discontinue any one of these drugs, I deteriorate. I am only partially improved, but the trend is towards recovery. The addition of prazosin has made all the difference.
Good luck.
- Scott
Posted by kagome on March 6, 2012, at 16:44:16
In reply to Re: More Parnate Questions » kagome, posted by SLS on February 29, 2012, at 5:58:00
> Please continue to post. I am very interested to see you get better. You have a few options to choose from to augment Parnate in case you don't respond well to it. The first thing is to see how well you tolerate a dosage of Parnate between 40 - 80 mg. If this is your first time on Parnate, you might find that dizziness becomes a limiting factor to rapid dosage escalation. This seems to get better with time, though.
Thanks, Scott, I can't tell you how nice this was to read. Wish I had forced myself to check messages earlier, but I've had a tough week of dragging myself from the bed to the couch and back again, with no other activity besides reading and watching tv. I've had a little dizziness on the Parnate but I think I'm more affected by the tiredness, and sleeping waaay too much. Hopefully that gets better with time also. Interestingly, my pdoc hasn't heard of going above 60, and I seem to remember you writing something elsewhere about it only beginning its neurotransmitter action around 80? Do you know of any articles I could show her?
I don't know why I'm not titrating up any faster (still on 30mg!) besides the fact that my pdoc doesn't know Parnate well and seems a little wary of it. Because I'm still doing so badly she added Abilify (it was between that and Zyprexa, and since I'm sleeping all the time I thought the more stimulating of the two would be better). So here's hoping that helps.
> One step at a time.
Yup. Just wish the steps were faster and less painful!> I am currently taking:
>
> Parnate 80 mg
> nortriptyline 150 mg
> Lamictal 200 mg
> Abilify 10 mg
> lithium 300 mg
> prazosin 6 mg
>
> I am responding to this treatment. If I attempt to discontinue any one of these drugs, I deteriorate. I am only partially improved, but the trend is towards recovery.I'm so glad to hear your combo is working out! I hope everyone here gets the break they need, but especially after all your hard work, good attitude, and helpfulness to everyone else (I've been reading up!) it does my heart good to see you getting some of the relief you so deserve.
> The addition of prazosin has made all the difference.
It's interesting I hadn't heard of prazosin before this but I'm going to mention it to my pdoc. It's pretty likely my childhood abuse is affecting my depression so something for PTSD would probably be good. I do have a lot of nightmares but my solution is usually just to go back to bed and hope for a better dream!
> Good luck.
You too, and thanks again!
This is the end of the thread.
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