Posted by Vincent_QC on January 7, 2009, at 16:29:42
Hi everyone ;-)
I just come back from my family doctor appointment. Finally, he said that I acted like a cowboy and at the same time put my health in danger. I will have to reduce my dose to 30mg/day, until I do at least a waiting time period of 1 month before I increase my dose again if no improvements are see at all. He said to not care about the official information from the GSK company about the fact that after 1 month at 30mg with no improve, its a sign that the treatment will not work.He decide this for several reasons that you can read under Hes not my « official» doctor now, since I got a new psychiatrist 2 months ago, my family doctor dont want to put himself and myself in a strange and bad position with double prescription and he dont want to interfere in my medical folder at the psychiatric hospital.
Im supposed to be only at 20mg now, so he said be back at 30mg before your appointment with your psychiatrist next week, and said to him you dont experience side-effect at 20mg/day and explain to him that you feel that its was time to augment the dose to 30mg and you do this augmentation last week.
My family doctor only give me one week supply of Parnate, so 21 pills of 10mg, just the amount I need to reach my next psychiatrist appointment. He absolutely wanted me to be at a lesser dose than 40mg for several reasons.
1-The fact that I had some spontaneous hypertensive crisis without food interaction and a lot of hypotension orthostatic problem from the 20mg to 30mg and more from the 30 to 40mg doses make me a more sensible person to the Parnate effect and the increase the Parnate do on certain neurons augmentation level in my brains (DA, Ne and ephedrine especially).
2-I play too much with my blood pressure since 2 weeks, he said Youre young, but I dont want to see you in the news paper in the dead section next week)He also add that encountering the blood pressure effect with Nifedipine, with all the results I got with hypertension and often hypotension, is not really a great thing to do, since the Nifedipine have an unpredictable effect on the blood pressure, it can lower too much my blood pressure
3-The fact that I had a gastric by-pass, especially the one I got, who work by malabsorption, and that my intestine is cut where the fat is absorb (and a lot of drugs are absorb too), make me a patient with a less predictable effects profile. My doctor dont know also if I can get a more high peak plasma level of Parnate in the blood because of my by-pass or a lesser peak plasma level of Parnate in my blood and say that I have to be really careful with the MAOIs drugs, since we dont know how many percent of my enzymes are destroy from the Type-A or Type-B and the dosage I need. My internal system dont work like a normal person, and I try almost any kind of drugs for cured my social phobia and I never react like the others patients he have, sometimes I had several side-effects from a specific drug at a very low dose and sometimes no side-effect at all at an extreme high doseSo I cannot just apply the same up-dosage profile or stage than someone else on this web forum.
4-He also explains that some evidence point the fact that some people with social phobia need higher dose to find a relief of their problem. But he also said for an example, that he see a lot of people with OCD and they was on high dose of a drug but they had only a positive answer after 3 monthsand he still dont know if the positive answer is due to the high dose of the drug or only the time the same apply with social phobia. Maybe at 30mg, I will feel more improve only after 3 monthsso he say Why act like a cowboy and play with your health like this and up your dose like you do if you dont let the time to do is action? Hes probably right about that. I put too much pressure and I want to go too fast. All the problem I had with my blood pressure and all the stress I got from this situation was completely unnecessary
So thats it, Im back to 30mg. At this stage, Im sure I will not have any hypertension or hypotension problem now, I will be able to breathe a little bit more without caring always my blood pressure machine to test it at night or during the day, I will feel more free also and not in dangerand overall less overstress with all of this. I will just have to caring with me a Nifedipine pill just in case I eat something wrong and thats it.
I also ask for something to sleep more well at night, since I do insomnia again, the first week at 40mg/day of Parnate make me feel tired a lot so I was sleeping more well at night, but since 3 days insomnia is back again. Since I low my valium intake, I barely need it at day time but I was taking more than half of my dose at bedtime to be able to fall asleep and stay asleep for a more long time. I ask him to give me some Seroquel but the regular version and only 25mgWith that, I will avoid the next day dizziness and I will sleep a little bit more well, I hopeRemember that with 50mg of Seroquel-XR, I had a very bad issue of next day sedation and I had a car accident in last December because of that.
Well, I will give the chance to the TIME variable to do his action and for one time in my life, listen to my doctor advice. Hes absolutely right, I think I played too much with my life in the last 2 weeks and the side-effects I had was not necessary to livedAnother time, I wanted to go more fast than the drug itselfOne of these day, I will learn my lesson.
I will hope the small improve in my social phobia will stay and dont fade away at 30mg/daywe will seeI will continue to give some update here for sure!!!
Thanks again everyone for your help ;-)
Have a nice end of day!!!
Vincent ;-)
poster:Vincent_QC
thread:872624
URL: http://www.dr-bob.org/babble/20090104/msgs/872624.html