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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by radish on July 5, 2019, at 12:26:30
Hello all. I started Parnate 10mg on Tuesday. By Wednesday I felt a slight improvement and by today, Friday, I feel 20% better with regards to many of the symptoms of my depression:
low mood
amotivation
apathy
anhedonia
hopelessness
irritability/intolerance
disinterest in others
low energy/fatigue
easily frustrated or overwhelmed
paralyzing avoidance of everything
obsessive ruminations
inability to concentrate
debilitating self-loathing and dysphoriaI believe these effects are not all placebo because I typically don't get a placebo effect from drugs, the effects are just so pronounced, and Parnate can start working very quickly as seen before on the forum. I may be in the initial wave of euphoria (although I am not experiencing that level of mood elevation) that I've read comes with the start-up of MAOIs and should not to be conflated with their long-term true anti-depressant effect.
It has NOT begun to affect my two most painful depressive symptoms: various forms of cognitive impairment (except my concentration IS improved!) and severe social anxiety. With regards to my concentration, I am finding it easier to focus at my job, whereas before I would work slowly and be bombarded with intrusive negative thoughts all day. I am able to concentrate on writing this post right now with better focus than I typically have for writing. I hope with time Parnate can improve anxiety/social anxiety because it is the main reason I am seeking psychiatric care. I've heard anecdotal reports from both sides; some people report it increases anxiety, while others state it helps them.
Side effects: It has lowered my appetite. It may be increasing my sex drive/desire. I do crash *hard* 7 hours after taking the dose wherein my mood falters and I generally feel depressed and vegetative again. In a couple weeks I will increase to 10mg twice a day and this should help.
Thanks for reading. I'll post more updates so I can aid my memory and in case anyone is interested.
Posted by sigismund on July 6, 2019, at 17:49:10
In reply to parnate 10mg helping mood after 3 days, posted by radish on July 5, 2019, at 12:26:30
How is your sleep?
Keep an eye on that as you increase.
Posted by Radish on July 16, 2019, at 12:55:40
In reply to Re: parnate 10mg helping mood after 3 days, posted by sigismund on July 6, 2019, at 17:49:10
Sleep has been ok. I've been on 10 mg for close to two weeks now. He initial burst of the warm antidepressant effect was gone after the first three days. It was nice as it made me unusually productive and stimulated. Now it helps lift me out of deep depression and into a more apathetic sleepy disconnected blah but fairly OK state which is an improvement for me. No effect on anxiety. I take ativan sometimes and this increases the spacey, sleepy blah feeling.
I occasionally use 20 mg a day (10 in AM, 10 in early afternoon) and am seeing how that efects me. I think I feel more blah but this is better than super depression. I don't want to die and my life and my problems do not torment and crush and paralyze me. I hope i experience the antidepressant qualities I found in my first few days again. But that may be unlikely.
Side effects have been dry mouth, lessened appatite, afternoon drowsiness, bit of weird blah spaciness. No insomnia.
Posted by TH on July 17, 2019, at 18:08:52
In reply to Re: parnate 10mg helping mood after 3 days, posted by Radish on July 16, 2019, at 12:55:40
Sounds very promising, and similar to my experience starting Parnate.
I began at 20mg and increased to 30mg after 10 days, as my blood pressure did not yet indicate full MAO inhibition (as explained here: https://psychotropical.info/wp-content/uploads/2018/05/4-MAOIs-Blood-pressure.pdf).
As best I can describe my experience beginning the treatment, it felt at first like I was so exhausted it was simply not possible to feel upset. After a few more weeks this exhaustion faded and only the helpful disconnect remained, and motivation started to come back; there was a drive to be productive.
It was a few more weeks after this that the sense of blah really started to lift and things began to feel properly okay, even happy at times.
Anxiety has never been a huge component of my illness, but I definitely tend to avoid social interaction when I am unwell. At this late stage, this also started to remit. I found that it took a lot less pushing myself to step outside my comfort zone and do something like go shopping for myself; I even made it as far as regularly playing open-mic night at the local pub.
Dry mouth and a bit of weird blah spaciness still hung around, but I didn't mind so much. In a way, I began to associate them with feeling well; it was reassuring to feel that something was physically different, and maybe helped create a physical distinction between my old life and my new one.
So to get to the point, stick with it! Your response sounds a lot like mine, and if that is the case (and 20mg is a high enough dose), things will likely only continue to improve.
Posted by Radish on July 18, 2019, at 18:25:25
In reply to Re: parnate 10mg helping mood after 3 days » Radish, posted by TH on July 17, 2019, at 18:08:52
Thank you for sharing. Thats really encouraging for me to hear. Do you still take parnate?
Posted by TH on July 19, 2019, at 1:34:01
In reply to Re: parnate 10mg helping mood after 3 days, posted by Radish on July 18, 2019, at 18:25:25
> Thank you for sharing. Thats really encouraging for me to hear. Do you still take parnate?
I do, at 40mg daily. It lost its effectiveness for a while (suspiciously, around the time the batch number changed), but I have been experimenting with crushing the tablets for about a week now and it seems like things are coming right again.
Posted by radish on July 23, 2019, at 17:14:14
In reply to Re: parnate 10mg helping mood after 3 days, posted by TH on July 19, 2019, at 1:34:01
that's good to hear TH, hopefully things continue to improve.
i have been on 20mg for two weeks now. i feel pretty awful again (for the past 4 days), about as bad as it gets for me. i have an appt in a few days and will ask to raise the dose. it's interesting that full MAO inhibition occurs at 20 mg and the benefits felt raising the dose above that come from other mechanisms at work. i could be wrong on that though.
Posted by TH on July 23, 2019, at 19:16:34
In reply to Re: parnate 10mg helping mood after 3 days, posted by radish on July 23, 2019, at 17:14:14
>It's interesting that full MAO inhibition occurs at 20 mg and the benefits felt raising the dose above that come from other mechanisms at work. i could be wrong on that though.
I had a feeling that full MAO inhibition didn't necessarily occur at 20mg for everyone, however it seems like you're right about the other mechanisms playing a large part in the effect. I try not to overthink any of this anymore, because we seem to just have generally no idea exactly why any given medication helps.
Posted by SLS on July 24, 2019, at 6:13:55
In reply to Re: parnate 10mg helping mood after 3 days, posted by TH on July 23, 2019, at 19:16:34
I have always acted under the belief that the effective dosage range for Parnate is 40-80 mg/day. Clearly, there are differences of opinion.
The following is an article regarding Parnate dosage that appears on a website that has a section devoted to the use of Parnate:
https://psychotropical.com/parnate-starting-and-adjusting-dose
- Scott
Posted by TH on July 24, 2019, at 20:03:22
In reply to Re: parnate 10mg helping mood after 3 days, posted by SLS on July 24, 2019, at 6:13:55
It is certainly appearing that 40mg may not be a sustainably therapeutic dose for me. I expect to increase the dose soon.
Posted by Radish on July 28, 2019, at 19:53:16
In reply to Re: parnate 10mg helping mood after 3 days » SLS, posted by TH on July 24, 2019, at 20:03:22
Had an appointment with psychiatrist the other day. He says I will stay on 20 mg for now until my next appointment perhaps.
He did some weird and incompetent impromptu therapy (more like a lecture) with me. Told me to believe in myself, to stop being so serious, to stop caring about what others think of me, to let go of whatever happened in my past that Im holding on to. I dont have anything in my past that I can remember that Im allowing to hold me back. Its NOT helpful for me to believe Im continually at fault for allowing my crushing depression and anxiety. He also said that Im allowing the medical and pharmaceutical establishment to profit off me by taking meds and not just uhh..fixing myself I guess? Basically everything he said implied my mental illness is my own fault and something I can will out of existence if I try hard enough. This makes me feel worse, not better. These concepts of reversing negative thought processes and changing your beliefs until youve fixed yourself creates further shame when you cannot get them to work for whatever reason despite trying really hard. thats why CBT in the past made me feel worse and lost credibility with me. I am upset with my doctor and confused. I dont know what to do. Its damaging to hear these things from an authority figure.
Posted by TH on July 29, 2019, at 6:41:45
In reply to Re: parnate 10mg helping mood after 3 days, posted by Radish on July 28, 2019, at 19:53:16
I'm sorry to hear that things have developed that way. I know first-hand how painful it can be to hear such a thing coming from qualified expert. I don't think you need to let his words get to you. If there's anything I've realised over the years of dealing with different doctors, it's that every one of them will have their own opinion on mental illness, many of them completely contradictory. I don't really think any one person (and certainly not me myself) has the full picture on what it takes to deal with this.
While what your doctor has said may absolutely be true for some patients, for others, it may be completely incorrect, and even damaging to hear. From what I've experienced, I strongly believe there are forms of mental illness which no amount of psychotherapy can ever significantly improve, however which may resolve quickly once an appropriate pharmacological treatment is found.
While I cannot recommend any unproven experimentation with meds, there are anecdotal reports that sublingual administration of Parnate may require lower doses to achieve the same degree of MAO inhibition. I have no idea whether this could be potentially unsafe, or whether it could modify the therapeutic effect.
Posted by radish on July 29, 2019, at 17:35:20
In reply to Re: parnate 10mg helping mood after 3 days » Radish, posted by TH on July 29, 2019, at 6:41:45
thank you for your reply... it really helped.
Posted by chumbawumba on August 27, 2019, at 10:42:00
In reply to Re: parnate 10mg helping mood after 3 days, posted by Radish on July 28, 2019, at 19:53:16
He's attempting to do psychotherapy, badly. Most psychiatrists aren't really trained in that. Most psychiatrists are about medication management. The best book on CBT IME is "Feeling Good: The New Mood Therapy" by David Burns It's a DIY thing if you have the energy to do some simple written exercises. Pretty damn helpful for something so simple. I found the written triple column technique for identifying and responding to cognite distortions helpful. Also the percent expected versus actual satisfaction worksheet.
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