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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Madnate on September 17, 2013, at 7:52:46
Hi everyone.
Thanks to this forum and your many postings and information I have gotten familiar with Parnate which I'm on since >2 years with amazing success (80mg/d) after everything else had failed during the last 10 years.
I was only able to get a pdoc to presribe it by providing a lot of information from Gillman and articles of magazines I had collected, because it's not directly available in my country and generally not used and even unknown (to the 3 pdocs I have spoken to at least).
This is one of the reasons for my post since we (see below) are pretty much on our own.I'm posting because of a friend of mine who suffers from Depression and OCD since about 15 years.
Always on and off of SSRIs, SNRIs, NRIs, TCAs and combos with atypical antipsychotics nothing had helped.This was very difficult to look at from my perspective since Parnate was this great success for myself and I had made the same experience with those newer, widely-used antidepressants.
During the past 2 years I have tried to convince her that it would make sense to give it a try.And finally she decided to do that.
She started Parnate 4 weeks ago.Since about 3 weeks she's on 20mg.
It's difficult for her to increase the dosage because she has to work and fears that the side effects would increase.
They are what you would expect from Parnate at the beginning:
weakness/tiredness, sometimes a little nausea that leads to appetite loss.
However she's still trying to increase the dosage and upped it to 25mg 2 days ago (plan is to at least reach 30-40mg if possible)I'm not sure whether my experience with the first weeks Parnate is so typical and would like to know what you think:
When I started it I was completely out for the first 2 weeks and could only lie down the whole day.
I'm not sure anymore which dose I took at that time. It was either 10mg or 20mg.
I already wanted to give up and was disappointed because it seemed to me that I couldn't tolerate it.
But since I didn't have to work and I was very desparate I decided to double the dose as a last resort and to discontinue if the next day was awful.
This is when it happened: It kicked in from one day to the next!
It was amazing.. I went from weakness/tiredness to feeling extremely well and motivated and had no tiredness at all anymore (except for the late afternoon phase).Did some of you experience it similarily?
Those typical Parnate side effects (weakness/tiredness) that went away from one day to another at the very same time it kicked in?
Or was it more of a steady progress (lessening of side effects while slowly improving?)
Of course it has to be different from case to case, it always is with those kinds of meds, but I'd be interested to know whether my experience was kinda weird or if that happens often.This experience leads me to believe that it's possible that for some people the side effects only disappear when Parnate kicks in, which might indicate that they won't go away when it does not, which is more likely to happen when you stay at a very low dose (or let's say a dosage that is too low for you).
Does this make sense to anyone? Also it's strange that side effects of Parnate don't seem to be completely related to the dose you take as it's with many other meds.
I just so hope that although it's already been 4 weeks, she will still have success at a higher dose. It's just so damn difficult to think about increasing it if you have to function during the day, already experience side effects and fear that they'd get worse.
Thank you very much for reading and your opinions :)
Have a nice day everyone,
Madnate
Posted by baseball55 on September 17, 2013, at 20:21:35
In reply to Parnate: initial side effects, dosage and duration, posted by Madnate on September 17, 2013, at 7:52:46
Parnate never made me tired. Just the opposite in fact. After three years on it, it still causes insomnia. The only other side effect I had was orthostatic hypotension. At first I had to be really careful getting up from a sitting or lying position, but now I barely notice it, though nurses notice it. I recently had major surgery and the nurses were alarmed by how much my BP dropped when I first stand up. But I no longer get dizzy. And that's it. No other side effects. I started on 30mg after a two-week washout in the hospital and felt better within 48 hours. I have still had episodes of severe depression over last three years, but not the kind of catatonic depression I had when I began the parnate. For over two years, I have been depression free, more or less.
Posted by Madnate on September 21, 2013, at 6:54:34
In reply to Re: Parnate: initial side effects, dosage and duration, posted by baseball55 on September 17, 2013, at 20:21:35
> Parnate never made me tired. Just the opposite in fact. After three years on it, it still causes insomnia. The only other side effect I had was orthostatic hypotension. At first I had to be really careful getting up from a sitting or lying position, but now I barely notice it, though nurses notice it. I recently had major surgery and the nurses were alarmed by how much my BP dropped when I first stand up. But I no longer get dizzy. And that's it. No other side effects. I started on 30mg after a two-week washout in the hospital and felt better within 48 hours. I have still had episodes of severe depression over last three years, but not the kind of catatonic depression I had when I began the parnate. For over two years, I have been depression free, more or less.
Hi baseball55,
thank you very much for your post.
And congrats that Parnate's also a success for you :)
48hrs is really a short time! It took me 10 days and I still wonder whether it had been sooner if I had taken a higher dose right from the beginning or sooner.
Anyone else?Do you think there's a chance that side effects like very mild nausea and dizziness/sleepyness may only subside when the dose is high enough (assuming it needs a high enough dose to actually kick-in)?
Let's say you are on 20mg all the time and side effects won't get better even after a month.
Is there a chance that those side effects won't increase but eventually fade when you increase the dose (assumed that leads to Parnate kicking in)?I just know that this definitely was the case when I started it. Wondered whether someone else had made similar experiences.
Posted by slimjim on July 8, 2016, at 18:39:09
In reply to Re: Parnate: initial side effects, dosage and duration, posted by Madnate on September 21, 2013, at 6:54:34
I know I am way too late to help the OP, but maybe someone else will benefit from this information. I am a MDD, Social Anxiety and Generalised Anxiety disorder sufferer.
I went through the merry go round of psych meds from 2002-2003 (Cipramil, Zoloft, Effexor, Paxil). Finally I found a psychiatrist, who tried me on Aurorix (Moclobemide a RIMA). Unlike the former, Aurorix worked. However, as described by one of the posters here, the initial week or two were hard.
I was dizzy, felt like I was in the clouds, and had insomnia. I needed to be driven around by others as I couldnt drive safely. After about 2 weeks at 300mg (a low dose) I woke up one day completely cured with no side effects (including no sexual ones which was massively important back then as I was early 20s in fact, it improved libido IMO). I was completely cured on it for about 7 years. It seemed to be losing its effect and I came off it with the intention of trying a TCA, however being off it was horrible and I went back on and was fine for another 3 years.
At this point I realised my Anxiety disorders were gone with our without meds. I put it down to age, as the same happened to my father who suffers as I do. Only MDD remained.
In 2013 it totally pooped out and I had the deepest darkest depression I have ever felt. So bad that it made me vomit a few times a day. We upped the dose of Aurorix slowly to 1200mg a day which is apparently the limit of my current psychiatrists comfort. At this level it didnt make any difference, and it was starting to make me dizzy anyway. No food reactions though, and I ate absolutely anything (this is not advice, just my experience).
I spent (wasted?) another 3.5 years trying all the new meds including Valdoxan + Aurorix, Brintellix on its own all the way up to 20mg, then Brintellix 10mg + Cymbalta 60mg. The latter combo made me feel like a zombie with about 1 degree of emotions either side of normal. It took 6-12 months and another bout of MDD to realise it wasnt really the cure for me. I also had trials of Seroquel, Modafinil and Lamotrigine as augmentation agents but I cant remember what combos they were in. They also didnt do much. Modafinil got me out of bed functioning, but I wasnt much happier.
Now, after what was an incredibly painless 2.5 week cold turkey off all psych meds (once again, experience, not advice!), I started on Parnate on Wednesday at 10mg, and its now Saturday and Ive increased it to 20mg yesterday. Honestly, I started to feel better within about 3-4 hours. Not cured but calmer. On day 4 and I am beginning to feel like a new man. I am getting up early (not me!), the intrusive dark thoughts are nearly gone, that invisible hand that tries to hold me into the chair whenever I think about doing any housework is getting a lot weaker.
I am also having nearly 0 side effects. No obvious hypotension, slightly difficult to go to sleep, but once asleep I am sleeping well, no nausea. One of the symptoms of my depression was insomnia anyway, so I dont knowThe only thing I have noticed is a mild headache throughout the day, and a slightly upset tummy. However, I was in the middle of an IBS attack when it started so who knows what is irritating my gut. No foods have reacted yet. I have noticed that music is amazing, and when a song I really like comes on I get regular rushes of tingles all over my body. Is this a side effect? As I quite like it :P
My experience with Parnate so far has been nothing short of amazing. Its too early to know if itll last, and Im not completely cured, but Ive gone from being nearly bed bound to jogging within a couple of days. I am excitedly waiting to see what happens after a month on 30mg.
I put my rapid response and lack of side effects down to the fact I spent nearly 10 years on Moclobemide. It feels similar, just a lot quicker and stronger.
If you are in Australia and suffer from hard to treat depression I encourage you to speak to your Psychiatrist about this med. I have had 3 Psychiatrists in my life, and all have been very willing to prescribe MAOI drugs to me after trying the newer meds. It was me that was too scared to start (I had a script for Nardil a year ago and chickened out back then).
Well, apologies for the long post, I hope it helps someone.
This is the end of the thread.
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