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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 violetdream on April 17, 2012, at 0:24:36
I started out Parnate for about 4 days on 10 mg, then moved up to 20 for a week or two. Now I've been on 30 for 2 weeks now.
When I started I felt numb and unable to cry or get upset by things that would normally upset me. It was kind of confusing since it was not my norm but it was "better". I was able to keep up with hygiene and taking vitamins every day, which I was earlier unable to do.
I have always suffered from obsessive worrying but I don't remember intrusive thoughts being this bad. I have always been sensitive to rejection but due to a number of recent major rejections time after time I have been left fairly crippled. I have been having a number of intrusive thoughts that get triggered by things only vaguely related to someone I was rejected by or they will just pop into my head at random. Sometimes it's as often as every minute or five minutes and I can get overwhelmed. Unlike OCD like behaviors, it's upsetting that I can't STOP the thought. It's just there. If you have a behavior, you can stop it once you have the thought, but I feel like I can't STOP the thoughts just with therapy. I know that MAOIs are treated for hair pulling (trich, can't spell the whole name) which I'm not sure has helped me that much, although I have a minor case. You'd think that if it helped with that, it would also help with these thoughts.
In addition to this I have developed possibly a mild case of BDD. I obsess about my appearance to the point where it takes hours and hours for me to feel ready to go out and even when I do I don't feel comfortable. I've been rejected by people so much that I feel like there's something wrong with me and it may be my appearance. I haven't ever had this that I can remember or at least to this extent before.
It's like I'm doing worse off now than when I started the parnate. I'm having too many days sleeping and lying in bed all day crying half the day and obsessing and ruminating and not being able to do a thing, basically paralyzed. Did it poop out? I'm guessing I need 60 if not more for my atypical depression. Has anyone experienced a worsening of symptoms during treatment? Is this normal, or a bad sign?
Posted by g_g_g_unit on April 17, 2012, at 0:59:41
In reply to Parnate: Increased Obessive thoughts/BDD?, posted by violetdream on April 17, 2012, at 0:24:36
I hate to play the 'me-too' game, but I've also noticed an increase in mental tension/OCD and BDD traits on 30mg. My BDD symptoms are relatively minor, and have been submerged for some time, but, for example, I find myself feeling incredibly 'ugly' due to the sleep deprivation and not wanting to be around others.
I'd presume it's the amphetamine-like effect at play. Someone please correct me if I'm wrong, but from what I understand, higher doses (i.e. 50-60mg) have a stronger serotonergic action and are therefore more anxiolytic. Last time I gave up because I was just feeling worse at 30-40mg, but this time I'm hoping 60mg will help. There's a report on askapatient from someone who found *remission* from BDD @ 80mg, and I believe Parnate is also a recommended treatment for the disorder.
Posted by violetdream on April 17, 2012, at 1:34:17
In reply to Re: Parnate: Increased Obessive thoughts/BDD? » violetdream, posted by g_g_g_unit on April 17, 2012, at 0:59:41
> I hate to play the 'me-too' game, but I've also noticed an increase in mental tension/OCD and BDD traits on 30mg. My BDD symptoms are relatively minor, and have been submerged for some time, but, for example, I find myself feeling incredibly 'ugly' due to the sleep deprivation and not wanting to be around others.
>
> I'd presume it's the amphetamine-like effect at play. Someone please correct me if I'm wrong, but from what I understand, higher doses (i.e. 50-60mg) have a stronger serotonergic action and are therefore more anxiolytic. Last time I gave up because I was just feeling worse at 30-40mg, but this time I'm hoping 60mg will help. There's a report on askapatient from someone who found *remission* from BDD @ 80mg, and I believe Parnate is also a recommended treatment for the disorder.No no, I love the me-too game, it makes me feel better :) I was wondering about the amphetamine action as well, but I never have felt a "high" on parnate. In fact I accidentally took 50mg (30 spaced out throughout the day and then 20mg at once later at night by mistake) and I just felt groggy. But I think you're right about the anxiolytic effect at higher doses.
I read the paper linked to Wikipedia that said that for very high doses, Parnate is extremely effective in treatment resistant depression, try looking up "High dose tranylcypromine therapy for refractory depression". Looks like the dose that people were responding at were 90-130, and I also found a BDD post on here where the poster was on 120.
I think I'm going to stick with it for sure. Do you know anything about how pdocs work going over 60? 120 would be max the maximum recommended dose...My current doctor is uncomfortable enough with MAOIs and it's proving very hard to find one who is.
Posted by g_g_g_unit on April 17, 2012, at 3:36:30
In reply to Re: Parnate: Increased Obessive thoughts/BDD?, posted by violetdream on April 17, 2012, at 1:34:17
I suppose I was referring to the fact that I'd also echoed maoiuser's sentiments in a recent thread - i.e. that Parnate makes me more impulsive. So I didn't wanna seem like a total copycat :)
I can't explain the lack of a 'high'. The first time I tried Parnate, the 'high' persisted for a little while, but there was none this time. I've also tried Dexedrine in the meantime (I think Parnate operates at 1/10 of the potency of Dexedrine, so if you've been on other stimulants, maybe it's simply too weak). Otherwise it could be another dopaminergic mechanism like MAO-B inhibition.
Sadly, I don't know about pdocs going over 60mg. I live in Australia (where the max. recommended dose is 30mg) and it took a bit of convincing to get my pdoc to agree to try the US max. of 60mg. I'd love to know how I could find a way to go higher (pending it's necessary). Maybe you could e-mail p-docs around your area, or ask for a recommendation here if you're comfortable revealing where you live?
> No no, I love the me-too game, it makes me feel better :) I was wondering about the amphetamine action as well, but I never have felt a "high" on parnate. In fact I accidentally took 50mg (30 spaced out throughout the day and then 20mg at once later at night by mistake) and I just felt groggy. But I think you're right about the anxiolytic effect at higher doses.
>
> I read the paper linked to Wikipedia that said that for very high doses, Parnate is extremely effective in treatment resistant depression, try looking up "High dose tranylcypromine therapy for refractory depression". Looks like the dose that people were responding at were 90-130, and I also found a BDD post on here where the poster was on 120.
>
> I think I'm going to stick with it for sure. Do you know anything about how pdocs work going over 60? 120 would be max the maximum recommended dose...My current doctor is uncomfortable enough with MAOIs and it's proving very hard to find one who is.
Posted by emmanuel98 on April 17, 2012, at 19:30:40
In reply to Re: Parnate: Increased Obessive thoughts/BDD? » violetdream, posted by g_g_g_unit on April 17, 2012, at 3:36:30
My p-doc will not go over 40mg. He says he's never prescribed more than this and if I want to try to go higher, he wants me to see a consultant who is more familiar with MAOIs. Problem is this consultant charges $375/hr, takes no insurance. I'm doing semi-okay most of the time, so I'm going to stick with what I'm taking.
Posted by g_g_g_unit on April 20, 2012, at 2:39:17
In reply to Re: Parnate: Increased Obessive thoughts/BDD?, posted by violetdream on April 17, 2012, at 1:34:17
Ugh, yeah, 30mg of Parnate is making me insanely anxious. Way more apparent since I dropped the Valium a week ago.
This is the end of the thread.
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