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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 TylerJ on March 11, 2006, at 14:15:53
I was looking at some old threads yesterday and found some about you taking 200 mgs. of Parnate daily..I found it quite interesting. I believe you said that you felt almost euphoric, more social, less fatigue, and your insomnia had vanished. If you don't mind, how long were you on this dose, and did you use any augmentation agents w/it? Did it eventually poop out on you?
Also, could you please give me a list, the more the better, of augmentation drugs you recommend with Parnate-just in case I need to augment. The only thing my pdoc will not consider is stimulants. Thanks Chairman.
Tyler
Posted by Chairman_MAO on March 11, 2006, at 17:33:58
In reply to Questions for Chairman _MAO, posted by TylerJ on March 11, 2006, at 14:15:53
The major problem I had was that the insomnia came back. The insomnia from Parnate is the most severe insomnia I've ever experienced, next to perhaps high doses of LSD or amphetamine. Given that I have PRIMARY insomnia, this was a big problem. If I had a less dogmatic doctor at the time I may have stayed on Parnate, as perhaps then I could've gotten strong enough downers to sleep well.
It never pooped out. I agree with Ivan Goldberg's assertion 100% that the biggest reason for treatment failure with Parnate is inadequate dosing. IMHO, the true therapeutic dose is ~1.5mg/kg. A 60mg/day maximum is not based in any reason except fear of litigation, perhaps, and that the drug only comes in 10mg tablets is absurd. It's basically a psychostimulant with 1/10th the potency of d-amphetamine.As for augmentation, please tell me what you are seeking to treat. Buprenorphine is a fantastic antidepressant.
Posted by TylerJ on March 11, 2006, at 17:51:37
In reply to Re: Questions for Chairman _MAO, posted by Chairman_MAO on March 11, 2006, at 17:33:58
> The major problem I had was that the insomnia came back. The insomnia from Parnate is the most severe insomnia I've ever experienced, next to perhaps high doses of LSD or amphetamine. Given that I have PRIMARY insomnia, this was a big problem. If I had a less dogmatic doctor at the time I may have stayed on Parnate, as perhaps then I could've gotten strong enough downers to sleep well.
>
>
> It never pooped out. I agree with Ivan Goldberg's assertion 100% that the biggest reason for treatment failure with Parnate is inadequate dosing. IMHO, the true therapeutic dose is ~1.5mg/kg. A 60mg/day maximum is not based in any reason except fear of litigation, perhaps, and that the drug only comes in 10mg tablets is absurd. It's basically a psychostimulant with 1/10th the potency of d-amphetamine.
>
> As for augmentation, please tell me what you are seeking to treat. Buprenorphine is a fantastic antidepressant.I was on Parnate in 1997 for 2 1/2 mos. it worked great and then for lack of a better word it pooped out...or like you say maybe the dose i was on was inadaquate. I was on 140 mgs.
Me and my pdoc are prepared to go higher this time if needed-I have no doubt he'll take me to 200 if needed. I'm currently on 90mgs and doing very well. What I'm looking for is probably based on fear that I will lose my response and won't be able to get it back. Augmentation meds such as mood stabilizes, other ad's, anti-convusants, beta-blockers, and anything you can think of to keep parnate working loner and better, of course when and if needed only. Again, my doc won't do stimulants. Please be honest with me, if you think only getting the dose right is what matters, and augmentation is not neccessary..I will definitely respect your opinion. Thanks.Tyler
Posted by Chairman_MAO on March 12, 2006, at 0:29:55
In reply to Re: Questions for Chairman _MAO » Chairman_MAO, posted by TylerJ on March 11, 2006, at 17:51:37
IF your doctor watches carefully for thrombocytopenia and other untoward effects, I imagine you could probably push the dose to 300-400mg/day if necessary.
I wouldn't worry about augmentation unless you start finding yourself becoming dysthymic. Then consider:
--Low-dose lithium is often surprisingly effective.
--Lamotrigine (possibily riluzole) has a good track record
--Memantine is an alternative to lamotrigine with fewer side effects
--Assuming you can get it, try amisulpride/sulpiride in low doses
--Direct dopamine agonists. In my order of preference based upon efficacy vis a vis tolerability: cabergoline > pramipexole/ropinirole/piribedil, bromocriptine > pergolide > lisuride, but YMMV.If you elaborate on what you suffer from, I will try to be more specific.
Posted by TylerJ on March 12, 2006, at 9:15:01
In reply to Re: Questions for Chairman _MAO » TylerJ, posted by Chairman_MAO on March 12, 2006, at 0:29:55
> IF your doctor watches carefully for thrombocytopenia and other untoward effects, I imagine you could probably push the dose to 300-400mg/day if necessary.
>
> I wouldn't worry about augmentation unless you start finding yourself becoming dysthymic. Then consider:
>
> --Low-dose lithium is often surprisingly effective.
> --Lamotrigine (possibily riluzole) has a good track record
> --Memantine is an alternative to lamotrigine with fewer side effects
> --Assuming you can get it, try amisulpride/sulpiride in low doses
> --Direct dopamine agonists. In my order of preference based upon efficacy vis a vis tolerability: cabergoline > pramipexole/ropinirole/piribedil, bromocriptine > pergolide > lisuride, but YMMV.
>
> If you elaborate on what you suffer from, I will try to be more specific.
>
>
>
>
I suffer from Atypical depression with some major dep. features, OCD, Social phobia, and GAD. With Parate after 5wks., I have no depression, no OCD, no social phobia, and no anxiety at all. Thanks.Tyler
P.S. Obviously I'm not worried about augmentation right now, but I would like to have some suggestions and advice to be prepared..."just in case". :)
This is the end of the thread.
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