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Dr. Bob is Robert Hsiung, MD,
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Posted by S. Suggs on January 1, 2000, at 11:51:07
In reply to Parnate Update, posted by S. Suggs on January 1, 2000, at 7:05:26
Many thanks for the rapid responses to my questions. FYI, I am dysthymic with ADD-H. Best wishes and blessings to all!!
S. Suggs
Posted by Scott L. Schofield on January 1, 2000, at 13:21:12
In reply to Re: Parnate Update-Thanks!, posted by S. Suggs on January 1, 2000, at 11:51:07
> Many thanks for the rapid responses to my questions. FYI, I am dysthymic with ADD-H. Best wishes and blessings to all!!
Have you ever tried a tricyclic?
- Scott
Posted by S. Suggs on January 1, 2000, at 15:45:18
In reply to Re: Parnate Update-Thanks!, posted by Scott L. Schofield on January 1, 2000, at 13:21:12
Have tried amitriptyline, nortriptyline, desipramine...I think that is all I can remember at this point. I do know that at one point I had a wonderful response to Zoloft and Pamelor, but due to GI problems (GERD)- TCA's can really be a problem when you have ongoing reflux. By the way I take Prevacid now and will go for the new endoscopic procedure within the next 6 months to correct this additional 110.00 med. Blessings,
S. Suggs
Posted by anita on January 1, 2000, at 16:33:53
In reply to Re: Parnate Update - Feeling Cold, posted by Scott L. Schofield on January 1, 2000, at 9:16:32
Hiya,
I had the same cold problem on Parnate, and on Nardil. On Parnate I only felt intense cold (like it was in my bones), but on nardil I had extremes in both feeling cold and feeling hot. It was severe, especially the hot part, with excessive sweating, and one of the main reasons I stopped nardil. I was on nardil for 3 years and it only got worse, but ymmv. BTW, on nardil my thyroid results were odd -- low TSH and low T4 & T3 -- but it was determined that this was a reaction to the drug and that nothing inherently was wrong with my thyroid. I did try thyroid supplementation (Cytomel), but that only made me anxious and hotter.
The worst for me was air conditioning, or a draft -- I'd get so cold no amount of blankets or heaters could warm me, and eventually my mind would get confused and I'd nod off. It was worse when I didn't get enough sleep.
I've always been curious about the temperature dysregulation with MAOIs, but never got any relief from it no matter what I did. Weird, eh?
anita
Posted by Scott L. Schofield on January 1, 2000, at 20:29:18
In reply to Re: Parnate Update-Thanks!, posted by S. Suggs on January 1, 2000, at 15:45:18
> > Have you ever tried a tricyclic?> Have tried amitriptyline, nortriptyline, desipramine...I think that is all I can remember at this point. I do know that at one point I had a wonderful response to Zoloft and Pamelor, but due to GI problems (GERD)- TCA's can really be a problem when you have ongoing reflux. By the way I take Prevacid now and will go for the new endoscopic procedure within the next 6 months to correct this additional 110.00 med.
I am curious (this occurs from time to time).
1. What properties of the tricyclics exacerbate your GI situation? Noradrenergic/anticholinergic, other?
2. What is Prevacid? How does it work?
3. What is a 110.00 med?
4. Why did the cow jump over the moon?I haven’t been here that long, and I don’t know any of your treatment history. If the endoscopic procedure is successful, will you be able to go back to a tricyclic? Are there any drugs that you can take that would abolish the GI effects of a tricyclic?
How about combining Zoloft and Wellbutrin instead? It seems to be an excellent combination for some people. Wellbutrin has also been used for AD/HD, although I don’t know how effective it is. In addition, it often counteracts the sexual side-effects of the SSRIs.
Thanks for providing any answers to the silly questions I have asked.
- Scott
Posted by ann faber on January 1, 2000, at 21:12:35
In reply to Re: Parnate Update-Thanks!, posted by Scott L. Schofield on January 1, 2000, at 20:29:18
>I don't understant how this works so I may be doing it wrong. Anyway, I have been one Nardil for about two years. I take 45mgs one day and 30 the next. I also take 35micrograms of cytomel and 100-150 of Seroquel. I also expereince the temperature disregulation problem. I go between sweating and freezing. I am 52, thought it was the "change" though I have always had warm flashes since on Nardil. Also, I have an odd question-has anyone experienced that their urine smells like burnt rubber with use of Nardil? Kind of like after you eat asparagus. Good luck with your explorations.
ann.
> > > Have you ever tried a tricyclic?
>
> > Have tried amitriptyline, nortriptyline, desipramine...I think that is all I can remember at this point. I do know that at one point I had a wonderful response to Zoloft and Pamelor, but due to GI problems (GERD)- TCA's can really be a problem when you have ongoing reflux. By the way I take Prevacid now and will go for the new endoscopic procedure within the next 6 months to correct this additional 110.00 med.
>
> I am curious (this occurs from time to time).
>
> 1. What properties of the tricyclics exacerbate your GI situation? Noradrenergic/anticholinergic, other?
> 2. What is Prevacid? How does it work?
> 3. What is a 110.00 med?
> 4. Why did the cow jump over the moon?
>
> I haven’t been here that long, and I don’t know any of your treatment history. If the endoscopic procedure is successful, will you be able to go back to a tricyclic? Are there any drugs that you can take that would abolish the GI effects of a tricyclic?
>
> How about combining Zoloft and Wellbutrin instead? It seems to be an excellent combination for some people. Wellbutrin has also been used for AD/HD, although I don’t know how effective it is. In addition, it often counteracts the sexual side-effects of the SSRIs.
>
> Thanks for providing any answers to the silly questions I have asked.
>
>
> - Scott
Posted by S. Suggs on January 2, 2000, at 4:55:15
In reply to Re: Parnate Update-Thanks!, posted by Scott L. Schofield on January 1, 2000, at 20:29:18
> I am curious (this occurs from time to time).
>
> 1. What properties of the tricyclics exacerbate your GI situation? Noradrenergic/anticholinergic, other? Anticholinergic-slow gi tract
> 2. What is Prevacid? - kissing cousin of Prilosec-Proton Pump Inhibitor-basically, one step beyond the zantacs of the world. Prevacid and Prilosec are once a day dose. How does it work? Not sure but it stops the process before it got to the step where ex. zantac / axid etc. would.
> 3. What is a 110.00 med? Sorry for lack of info. This is my term for a month's supply. I pay for all my meds out of pocked and submit on my own and get 80% back in about a month-better than nothing.
> 4. Why did the cow jump over the moon? He doubled his Nardil dose with an extra bottle of red wine.
>
> I haven’t been here that long, and I don’t know any of your treatment history. If the endoscopic procedure is successful, will you be able to go back to a tricyclic? ae there any drugs that you can take that would abolish the GI effects of a tricyclic? Probably could go back to a TCA, but the side effects I can put up with right now. I just want to get off the Prevacid. It was also discovered that I have a hiatial hernia (part of my stomach sticks up through my diaphragm).
>
> How about combining Zoloft and Wellbutrin instead? It seems to be an excellent combination for some people. Wellbutrin has also been used for AD/HD, although I don’t know how effective it is. In addition, it often counteracts the sexual side-effects of the SSRIs. This could be a possibiblity in the future, and thanks for the suggestion, but I probably will stick where I am unless things get worse. By the way, my doc gave me the permission to slowly increase above the 60 mg (FDA max) if necessary. He said I was probably the only one of his patients he would allow to do so, based on my increased knowledge. And to all reading, this is another reason Psycho-Babble is crucial to keeping educated. He tells me I have educated him on MAOI's. But 60 works great (excluding a few side effects).
>
> Thanks for providing any answers to the silly questions I have asked. Thank you for giving me a chance to respond, please continue with further ones, it allows me to share my experiences with others who might need it. BlessingsS. Suggs
>
>
> - Scott
Posted by S. Suggs on January 2, 2000, at 4:58:43
In reply to Re: Parnate Update-Thanks!, posted by ann faber on January 1, 2000, at 21:12:35
It seems that temperature deregulation is a common side effect that is not mentiond (unless I've missed it). Do not have any idea about the burnt rubber thing. Good luck and blessings,
S. Suggs
Posted by Scott L. Schofield on January 2, 2000, at 11:28:10
In reply to Re: Parnate Update-Thanks!, posted by S. Suggs on January 2, 2000, at 4:55:15
> By the way, my doc gave me the permission to slowly increase above the 60 mg (FDA max) if necessary. He said I was probably the only one of his patients he would allow to do so, based on my increased knowledge. And to all reading, this is another reason Psycho-Babble is crucial to keeping educated. He tells me I have educated him on MAOI's. But 60 works great (excluding a few side effects).
If it ain’t broke, don’t fix it.
My doctor uses a range of 40mg – 80mg per day as his therapeutic standard. In my case, he has worked me up to dosages as high as 150mg/day. This is not all that rare. It should be noted that Parnate exhibits properties at a high dose that it does not at a standard dose. If there is one common gripe regarding the use of Parnate (and many other antidepressants) is that the dosage is not pushed high enough, and that the trial is not continued for long enough.
I’m pretty sure you can find this information at either the Dr. Bob’s Tips section or at Ivan Goldberg’s Depression Central.
- Scott
Posted by Elizabeth on January 3, 2000, at 9:33:11
In reply to Re: Parnate Update-Thanks!, posted by Scott L. Schofield on January 2, 2000, at 11:28:10
> > By the way, my doc gave me the permission to slowly increase above the 60 mg (FDA max) if necessary. He said I was probably the only one of his patients he would allow to do so, based on my increased knowledge. And to all reading, this is another reason Psycho-Babble is crucial to keeping educated. He tells me I have educated him on MAOI's. But 60 works great (excluding a few side effects).
>
> If it ain’t broke, don’t fix it.
> It should be noted that Parnate exhibits properties at a high dose that it does not at a standard dose.Any properties I should know about?
Posted by cn. michele on January 3, 2000, at 11:41:59
In reply to Parnate "properties" :), posted by Elizabeth on January 3, 2000, at 9:33:11
> > > By the way, my doc gave me the permission to slowly increase above the 60 mg (FDA max) if necessary. He said I was probably the only one of his patients he would allow to do so, based on my increased knowledge. And to all reading, this is another reason Psycho-Babble is crucial to keeping educated. He tells me I have educated him on MAOI's. But 60 works great (excluding a few side effects).
> >
> > If it ain’t broke, don’t fix it.
> > It should be noted that Parnate exhibits properties at a high dose that it does not at a standard dose.
>
> Any properties I should know about?I am thinking about Parnate for relief of GAD/depression would you mind posting any side-effects your have experienced with this drug. Thanks, Michele
Posted by Frymet on January 3, 2000, at 15:42:22
In reply to Parnate Update, posted by S. Suggs on January 1, 2000, at 7:05:26
Did your doctor check you kidney function?
Lithium can cause kidney problems and perhaps the combination may increase the possibility.
Posted by Scott L. Schofield on January 3, 2000, at 17:01:24
In reply to Parnate "properties" :), posted by Elizabeth on January 3, 2000, at 9:33:11
> > It should be noted that Parnate exhibits properties at a high dose that it does not at a standard dose.
>
> Any properties I should know about?When I get a chance, I'll see if I can find some of the stuff about it. I'm sure you would be quite interested to know about them, but nothing I read indicates any kind of risk involved with these dosage-emergent pharmacodynamic effects.
- Scott
Posted by S. Suggs on January 3, 2000, at 18:55:50
In reply to Parnate Update-response to S.Snuggs, posted by Frymet on January 3, 2000, at 15:42:22
>
> Did your doctor check you kidney function?
> Lithium can cause kidney problems and perhaps the combination may increase the possibility.Just curious, what type of kidney function test are you mentioning. (I believe in leaving no stones unturned - no pun intended). Thanks and many blessings,
S. Suggs
Posted by Elizabeth on January 4, 2000, at 19:26:47
In reply to Re: Parnate "properties" :), posted by Scott L. Schofield on January 3, 2000, at 17:01:24
> When I get a chance, I'll see if I can find some of the stuff about it. I'm sure you would be quite interested to know about them, but nothing I read indicates any kind of risk involved with these dosage-emergent pharmacodynamic effects.
Thanks -- I'd appreciate that. I am interested to hear what you've found about high-dose Parnate. I'm thinking seriously of switching back due to weight gain on Marplan. I suggested maybe trying to figure out a way to get the Parnate dose a little higher than I did before, which my pdoc referred to -- with a smile -- as "cowboy psychopharmacology." :-)
Posted by Adam on January 4, 2000, at 22:07:09
In reply to Re: Parnate "properties" :), posted by Elizabeth on January 4, 2000, at 19:26:47
>I suggested maybe trying to figure out a way to get the Parnate dose a little higher than I did before, which my pdoc referred to -- with a smile -- as "cowboy psychopharmacology." :-)Not trying to be a pain here...
I'd be very interested in hearing about this "cowboy psychopharm." if and when you can share such info. (I promise no more talk of selegiline, or anything else!...I'm just interested)
Thanks! :)
Posted by Michael on January 5, 2000, at 5:54:08
In reply to Parnate Update, posted by S. Suggs on January 1, 2000, at 7:05:26
> I've Been on Parnate for about 2 months. Without a doubt, there has been a very positive response. Some strange things have happened (I must mention that I take lithium 900 mg, and started at 600 mg around 3 1/2 years ago). What I have noticed are: Increased thirst (never before with the lithium) and therefore increased urination. Early evening becomming very sleepy, and therefore having no trouble with sleep, whatsoever. Here is the strang one: Very intense cold intolerance (Columbia, SC). I wonder if this one is related to thyroid, so I had my doc run a tsh, which came back "normal", which we all know my not mean anything at all. These are in my opinion small side effects which by far outweigh the depression. I have a better outlook on life, more energy etc... It's the cold intolerence thing that is really strange, what do my fellow babblers in their fountain of knowledge think? happy new year blessings,
>
> S. SuggsHaving been on Parnate for many years, I also experience cold intolerance. Fortunately, there are few other side effects.
Posted by S. Suggs on January 5, 2000, at 6:15:20
In reply to Re: Parnate Update, posted by Michael on January 5, 2000, at 5:54:08
Michael, thanks for the reply. The cold intolerance is a minor side effect that I can put up with. What I've also noticed is a huge improvement in the social aspect. For ex. while at Home Depot (wood worker and tool freek) I,m talking briefly to strangers and just being plain nice. Also, when the Parnate wears off, I do crash (get sleepy), this is fine since I end up getting a full and restful nights sleep. For years I never slept well. It's good (I've tried so many AD's).
My main question to you is what is your dose of Parnate, I'm at 60?
Blessings,
S. Suggs
Posted by Elizabeth on January 5, 2000, at 19:31:05
In reply to Re: Parnate "properties" :), posted by Adam on January 4, 2000, at 22:07:09
> I'd be very interested in hearing about this "cowboy psychopharm." if and when you can share such info.
I'm sort of confused by this...can you rephrase the question please?
Posted by Phillip Marx on January 6, 2000, at 1:31:01
In reply to Re: Parnate Update-Thanks!, posted by ann faber on January 1, 2000, at 21:12:35
> >Also, I have an odd question-has anyone experienced that their urine smells like burnt rubber with use of Nardil? Kind of like after you eat asparagus. Good luck with your explorations.
>
> ann.Burning rubber smell (urine?)
http://www.childrenwithdiabetes.com/dteam/1999-06/d_0d_3wu.htm
http://www.med.harvard.edu/AANLIB/cases/case25/mr1/013.html
http://williamcalvin.com/bk7/bk7ch5.htm
http://www.google.com/search?q=burning+rubber+smell+urine&num=10&sa=Google+Search
I’m going to be asleep in a few minutes so I can’t say more.
Lucky us.
pm
Posted by Noa on January 6, 2000, at 6:17:11
In reply to --burnt rubber - urine--, posted by Phillip Marx on January 6, 2000, at 1:31:01
> I’m going to be asleep in a few minutes so I can’t say more.
>
> Lucky us.
>
> pmPhillip, LOL. I am glad to see you have a good sense of humor.
Posted by Adam on January 6, 2000, at 12:38:04
In reply to Re: Parnate "properties" :), posted by Elizabeth on January 5, 2000, at 19:31:05
> > I'd be very interested in hearing about this "cowboy psychopharm." if and when you can share such info.
>
> I'm sort of confused by this...can you rephrase the question please?Sure. If I remember correctly, one of the difficultites you had with Parnate was recurrent spontaneous hypertensive crisis at a relatively low (but promisingly therapeutic)dose. I assume "cowboy psychopharmacology" might refer to creative, perhaps unorthodox, strategies to increase Parnate dosage while minimizing or eliminating ill effects. If the above is true and you are comfortable discussing, I would be interested in hearing what you are trying and how it is working.
Thanks again!
Posted by Phillip Marx on January 6, 2000, at 14:04:08
In reply to Phillip has a sense of humor!, posted by Noa on January 6, 2000, at 6:17:11
How could I have been more to the point and still had my point missed? Re-synchronize target points. Target below: Center dot first. First concentric ring second. Second concentric ring third. Fourth: bales of hay backguard. Fifth: contest arena. Sixth: prizes for all participants.
Ann, There are some internet hints at what you are asking. The first one is almost congruent, had only a "not here" for an answer, but shows you aren't alone.
The second specifically identifies which part of the brain is damaged by an encephalitis (brain infection) that could be caused by a Herpes virus. These can be fatal if not treated with acyclovir. The danger stage is apparently synchronous with a hallucinatory or distorted, off-true, olfactory sense. Be prepared. A preserved sample specimen could uncapsize a diagnostic drift towards that direction. Presentation of such a sample to an actual urologist might be the smartest place to start next, since neuropsychiatrists are preoccupied with neuropsychiatric faults matched to symptoms.
Another related to actual hallucinations of smells, which ref I lost, too much of a stretch to apply to you, since yours seemed annoyingly persistent and oriented as to time and place, which isn't always a hallucination disqualifier. For thouroughness though, it should be in your information collection so that you can have your diagnosis re-centering rebuttals in place for oddball pitches and games. The faster that trash gets identified as trash, the faster it gets thrown out. If it's not true and they won't give it up, then bail out, find a plane with a better pilot.
The fourth is a localized brain seizure/false activation disorder they may very evasively try to rule-out. Patient worry avoidance tactics can result in patient sensitivity testing for a given subject that skirt the subject from such a distance you will never know what it is you might have had. Prep-up. Fix-up fears should be far less that never-fixed-up fears.
I'd draw the 3-D diagnostic tree-molecule-cloud, with the cloud envelope, the fog-globs and all, but my data bank is too empty from insufficient deposit. I'd be critically afraid to post it.
Hmmm. I'm not so sure what was funny. I try to put a little anti-depressant (humor) spin in nearly everything I write, maybe if I didn't spread it out so much I would do better. All this perception from the inside out stuff is interesting to me since I come from the world that looks at the inside from the outside. This is sure harder than fixing mere computers.
> >Also, I have an odd question-has anyone experienced that their urine smells like burnt rubber with use of Nardil? Kind of like after you eat asparagus. Good luck with your explorations.
>
> ann.
Burning rubber smell (urine?)A nearly identical question from elsewhere.
I might add, is it a sulphurous burning rubber?
Any sulphates from foods or pills being excreted? Any nervous eraser chewing? Any unstable enemies near your food? Twinkies?
> > I’m going to be asleep in a few minutes so I can’t say more.
> >
> > Lucky us.
> >
> > pm
>
> Phillip, LOL. I am glad to see you have a good sense of humor.Though I'm glad to have something that gets me to sleep real fast if I run around my block, sometimes I'd like to learn to stretch it a few minutes more easily.
pm p.s. Fun sites showing the perceptions of those with "outside-in" perspective:http://www.crd.ge.com/esl/cgsp/projects/medical/
http://www.williamcalvin.com/
http://www.med.harvard.edu/AANLIB/home.html
http://www.indiana.edu/~primate/
http://www.cs.utexas.edu/users/nn/web-pubs/htmlbook96/
http://www.nlm.nih.gov/research/visible/
http://metalab.unc.edu/jstrout/uploading/MUHomePage.html
http://www-hbp.scripps.edu/HBP_html/HBPsites.html
http://sulcus.berkeley.edu/
http://www.wjh.harvard.edu/~kwn/kosslab.html
http://www.bic.mni.mcgill.ca/
http://hebb.uoregon.edu/brainlab/belHome.html
http://www.wlu.edu/~web/bp/brainpk.html
http://faculty.washington.edu/chudler/ehc.html
http://www.neuropsychologycentral.com/index.html
http://www.neuroscience.cnter.com/
http://www.neuroguide.com/
http://neuro-www2.mgh.harvard.edu/MIND/Poetry/submit.html
http://neuro.med.cornell.edu/VL/
I can't get a couple of others to still work, later maybe. A few of these are really different from when I last looked. Endless mindfullness.
pm
Posted by Elizabeth on January 7, 2000, at 8:54:00
In reply to Re: Parnate "properties" :), E, posted by Adam on January 6, 2000, at 12:38:04
> Sure. If I remember correctly, one of the difficultites you had with Parnate was recurrent spontaneous hypertensive crisis at a relatively low (but promisingly therapeutic) dose. I assume "cowboy psychopharmacology" might refer to creative, perhaps unorthodox, strategies to increase Parnate dosage while minimizing or eliminating ill effects. If the above is true and you are comfortable discussing, I would be interested in hearing what you are trying and how it is working.
Aha. Okay. I'm still on Marplan right now, but considering returning to good ol' Parnate because of that insidious weight gain.
One thing my therapist suggested when I mentioned this to him was to try adding verapamil or some other Ca++ antagonist to the Parnate to keep my BP stable.
I'm ambivalent about switching -- like anybody, I don't relish the idea of ballooning like I did on Nardil, but at the same time, switching MAOIs is truly painful due to withdrawal symptoms and that pesky waiting period (I thought those were for handguns!). I can't decide whether it's worth the risk, especially since the spring semester begins in a couple weeks. (I *don't* want to have to go to the hospital right now!)
Posted by Adam on January 7, 2000, at 9:51:32
In reply to Re: Parnate "properties" :), posted by Elizabeth on January 7, 2000, at 8:54:00
>
> Aha. Okay. I'm still on Marplan right now, but considering returning to good ol' Parnate because of that insidious weight gain.
>I HATE that.
> One thing my therapist suggested when I mentioned this to him was to try adding verapamil or some other Ca++ antagonist to the Parnate to keep my BP stable.
>
Thanks for sharing!> I'm ambivalent about switching -- like anybody, I don't relish the idea of ballooning like I did on Nardil, but at the same time, switching MAOIs is truly painful due to withdrawal symptoms and that pesky waiting period (I thought those were for handguns!). I can't decide whether it's worth the risk, especially since the spring semester begins in a couple weeks. (I *don't* want to have to go to the hospital right now!)
Best of luck to you!
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