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Dr. Bob is Robert Hsiung, MD,
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Posted by vanvog on April 4, 2013, at 3:53:24
I've been on Parnate for 12 weeks now, 2 weeks on 100 mg/day. My pDoc finally approved 120 mg/day which according to most hardcore long-timers is entering serious territory.
I'm somewhat anxious and excited at the same time, so far Parnate did help a lot but I have some serious side effects which almost made me go off it: extreme fatigue and severe anhedonia. No energy, no motivation, nothing gives me pleasure but I'm no longer depressed or suicidal like I used to be. Alternating hypersomnia and insomnia, I sleep 14-16 hours/day and on some days I need 2-3 naps. I'd say I feel 60% remission of my symptoms overall. I'm a big guy, 120 mg is ~1mg/kg for me. My fear is that 120 mg/day will not make me feel that much better and augmenting is out of question at the moment according to my pDoc.
My pDoc warned me that under no circumstances is he willing to prescribe more than 120 mg/day because he normally would not prescribe more than 80 mg/day for severe out-patients, so he is doing me a huge favor already which required a lot of convincing and involved some back and forths.
I would really appreciate some advice and would like to hear some experiences on 100 mg/day vs. 120 mg/day of Parnate. Thanks.
Posted by SLS on April 4, 2013, at 11:46:00
In reply to PARNATE 100 vs. 120 mg/day experiences please!, posted by vanvog on April 4, 2013, at 3:53:24
It is my impression that the lowest dosage used in a high-dose Parnate strategy is 120 mg/day. For me, no additional side effects emerged at that dosage. I went up to 150 mg/day. I found higher dosages to be more helpful than lower dosages. High dosages seem to downregulate 5-HT2a receptors in a way that lower dosages do not. This may be an indicator that adding nortriptyline at some point might make sense as it is a 5-HT2a receptor antagonist.
- Scott
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