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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by eric wagner on July 27, 2008, at 17:13:17
I would like to know if anyone has used Parnate at an adequate dose for a full trial & never had a positive response
Also, anyone who has aquired positive effects - how long did it take to notice them, & at what dose were you on?I have been on Parnate for approx. 5 weeks now
I'm currently on 50 mgs./day (morning dose) & will increase it to 60 mgs./day at the end of the month
I have yet to see any positive effects/lessening of symptoms as of yetThis is nothing new for me, as I have tried many different types in all classes of antidepressants w/ no response whatsoever
The only medication I have ever had a positive response from was Daytrana, although that was short lived, as it pooped out after 2 weeks
The positive effects/lessening of ALL symptoms ceased all 5 times I had restarted a new prescription w/ a couple week break in betweenAny response/info. on your Parnate experiences - whether positive or negative - will be much appreciated
Take Care & Be Well,
Eric M. Wagner
Posted by Justherself54 on July 27, 2008, at 17:25:12
In reply to Full trial of Panate w/ no response?, posted by eric wagner on July 27, 2008, at 17:13:17
Hi Eric..I'm on my second trial of Parnate and this time it is not working anywhere like it did before. The first time I couldn't get to 30 mg due to extreme hypotension, this time I'm at 40 mg and my BP is not too bad. First time within a week I felt a difference, this time a bit of a lift with depression but now I've got constant rumination...I feel I'm barely responding..
I can see how you would be frustrated. I'm beginning to think with MAOI's if you get all the side effects, it's going to work...if you don't, then it's not...I have nothing scientific to back this up...just personal experience.
Nardil was terrible for side effects, but it worked great for depression and social anxiety..one side effect caused me to go off it...
On the other hand 5 weeks on a MAOI is a short time...my first shot at parnate with it working so quickly was unusual I think. I'd give it more time to see if it's going to kick in.
BYW, are you having any side effects?
Posted by eric wagner on July 27, 2008, at 17:39:19
In reply to Re: Full trial of Panate w/ no response?, posted by Justherself54 on July 27, 2008, at 17:25:12
> Hi Eric..I'm on my second trial of Parnate and this time it is not working anywhere like it did before. The first time I couldn't get to 30 mg due to extreme hypotension, this time I'm at 40 mg and my BP is not too bad. First time within a week I felt a difference, this time a bit of a lift with depression but now I've got constant rumination...I feel I'm barely responding..
>
> I can see how you would be frustrated. I'm beginning to think with MAOI's if you get all the side effects, it's going to work...if you don't, then it's not...I have nothing scientific to back this up...just personal experience.
>
> Nardil was terrible for side effects, but it worked great for depression and social anxiety..one side effect caused me to go off it...
>
> On the other hand 5 weeks on a MAOI is a short time...my first shot at parnate with it working so quickly was unusual I think. I'd give it more time to see if it's going to kick in.
>
> BYW, are you having any side effects?Thank you for response & info.
I appreciate it
As far as side effects - I dont really have any bad ones - or they could just be because I dont feel well
First couple weeks I felt kind of sick
Now, possibly slight irritability, insomnia, lightheadedness - if they are even from the Parnate - or still lasting withdrawal effects from being on many different types of stimulants for months
Take Care
Eric M. Wagner
Posted by bleauberry on July 27, 2008, at 19:12:14
In reply to Full trial of Panate w/ no response?, posted by eric wagner on July 27, 2008, at 17:13:17
Sorry I can't help on Parnate much, other than to say give it a higher dose and longer time. I've heard people needed twice the dose you are taking, and that a good trial is in the neighborhood of 12 weeks.
And I'm sorry you are in the same boat as many of us. Hopefully we can swap ideas and make some advancements.
I wonder if your diagnosis is accurate? I mean, depression, sure. But from what? At this point you kind of have to question the whole deficient transmitter thing in your case. Other things cause depression besides just that. Even if you have zero bipolar symptoms, ever tried abilify, lamictal, depakote, stuff like that? Dopamine agonists? Other ADs popular everywhere else in the world except USA? Japan's premier AD is Milnacipran. I heard of someone who failed ECT and responded to Milnacipran. Tianeptine is another one. I can vouch for both of these, personal experience, as being a world different than what the FDA limits us to. And there is low dose Amisulpride. And if you did ok with the stimulants, maybe all you needed to do was add Memantine to them to revive their initial effects.
Hopefully Parnate will do something with more time and a higher dose. If not, at least then you know it would probably be a good move to look at things with totally different mechanisms than the reuptake/maoi route.
Anyway, long story short, fingers crossed things will go your way in the next 2 months and if they don't then look beyond the monoamine theory.
Posted by Zeba on July 27, 2008, at 23:54:40
In reply to Full trial of Panate w/ no response?, posted by eric wagner on July 27, 2008, at 17:13:17
Eric,
Could you please describe the response you are looking for. I feel Parnate is working for me. This is not to say I don't get down in the dumps and feel depressed at times. It means I am not feeling a constant depression. I am in therapy too, and so part of my up and down feeling has to do with what is happening in therapy. Even so, I am not looking for a good feeling every day. So, this is why I am curious as to what sort of response you are looking for. Are you so depressed you can't function, or is it more like a low grade fever type thing or something else? I really am interested in knowing.
Zeba
Posted by blueboy on July 28, 2008, at 11:31:24
In reply to Full trial of Panate w/ no response?, posted by eric wagner on July 27, 2008, at 17:13:17
> I would like to know if anyone has used Parnate at an adequate dose for a full trial & never had a positive response
> Also, anyone who has aquired positive effects - how long did it take to notice them, & at what dose were you on?
>
> I have been on Parnate for approx. 5 weeks now
> I'm currently on 50 mgs./day (morning dose) & will increase it to 60 mgs./day at the end of the month
> I have yet to see any positive effects/lessening of symptoms as of yet
>I would say that this is not a "full trial". As long as you can tolerate the side effects, you should keep gradually upping the dosage, giving each dosage at least two weeks.
IMHO, after a five week titration period, the chances of successful response are fairly low. You may need to be *at* therapeutic dosage for ten days to two weeks before your mood brightens, and your therapeutic dosage could be significantly over 60mg/day. Unfortunately, the side effects normally start before the mood brightening.
The good things about MAOI's is that they have an extremely high success rate. The bad news is that the side effects are so nasty, a lot of people just can't tolerate them.
Posted by eric wagner on July 28, 2008, at 12:01:06
In reply to Re: Full trial of Panate w/ no response? » eric wagner, posted by Zeba on July 27, 2008, at 23:54:40
> Eric,
>
> Could you please describe the response you are looking for. I feel Parnate is working for me. This is not to say I don't get down in the dumps and feel depressed at times. It means I am not feeling a constant depression. I am in therapy too, and so part of my up and down feeling has to do with what is happening in therapy. Even so, I am not looking for a good feeling every day. So, this is why I am curious as to what sort of response you are looking for. Are you so depressed you can't function, or is it more like a low grade fever type thing or something else? I really am interested in knowing.
>
> ZebaZeba,
I am hoping for:
Less depressed feeling(s) / negative thoughts / hopelessness
Ability to leave house, go to stores, go back to work, start exercising again, have fun, enjoy recreational activities / hobbies, etc.
Lessening of very poor energy
Increase in motivation / a love for life / pleasure
Hope for getting better / the future / life
Lessening of anhedonia
Lessening of fear / antisocial behavior / isolatingThis may be asking for a lot, like a miracle drug/response, but anything is better than my current state which has been bad for years
Daytrana (Methylphenidate) produced a response on all of the above, although short lived, so hopefully it's possible for another medication to produce the same
Posted by eric wagner on July 28, 2008, at 12:16:01
In reply to Re: Full trial of Panate w/ no response?, posted by bleauberry on July 27, 2008, at 19:12:14
> Sorry I can't help on Parnate much, other than to say give it a higher dose and longer time. I've heard people needed twice the dose you are taking, and that a good trial is in the neighborhood of 12 weeks.
>
> And I'm sorry you are in the same boat as many of us. Hopefully we can swap ideas and make some advancements.
>
> I wonder if your diagnosis is accurate? I mean, depression, sure. But from what? At this point you kind of have to question the whole deficient transmitter thing in your case. Other things cause depression besides just that. Even if you have zero bipolar symptoms, ever tried abilify, lamictal, depakote, stuff like that? Dopamine agonists? Other ADs popular everywhere else in the world except USA? Japan's premier AD is Milnacipran. I heard of someone who failed ECT and responded to Milnacipran. Tianeptine is another one. I can vouch for both of these, personal experience, as being a world different than what the FDA limits us to. And there is low dose Amisulpride. And if you did ok with the stimulants, maybe all you needed to do was add Memantine to them to revive their initial effects.
>
> Hopefully Parnate will do something with more time and a higher dose. If not, at least then you know it would probably be a good move to look at things with totally different mechanisms than the reuptake/maoi route.
>
> Anyway, long story short, fingers crossed things will go your way in the next 2 months and if they don't then look beyond the monoamine theory.I'm trialing this Parnate for the long haul, being one of the last possibilities of medications left
I was on Emsam for 3 months w/ no response whatsoever, so hopefully this MAOI will work
I feel my depression may be genetic, a result of trauma/abuse as a child, drug / alcohol use / abuse for 13 years, and / or some other possibility
All of your suggestions listed are very good ones, & thoughts I've had of trying for a while
I've already spoke to my Psychiatrist about the possibility of filling out the FDA form to use a non-approved medication, if Parnate fails to provide an acceptable response
We've tried just about everything approved by the FDA
Maybe the Daytrana/Memantine combo would be a good trial prior to a medication not approved in the US
Do you know of any posts where people have used Memantine in combination w/ a stimulant & got the response they were hoping for?
Thank you for your response, info. & very appreciated suggestions / possible routes to try
Take Care & Be Well,
Eric M. Wagner
Posted by bleauberry on July 28, 2008, at 20:25:14
In reply to Re: Full trial of Panate w/ no response?, posted by eric wagner on July 28, 2008, at 12:01:06
>
> Daytrana (Methylphenidate) produced a response on all of the above, although short lived, so hopefully it's possible for another medication to produce the same
>Too bad Memantine isn't better known. There have been some striking miraculous stories, even right here at pbabble, of people waking from the dead when Memantine was added to their meds, mostly based around stimulants like Ritalin or Modafinil.
Memantine has shown anecdotal evidence of preventing and reversing the poopout/tolerance of Ritalin, allowing Ritalin to keep on working and at a lower dose. No way to predict if it would work with you or not, but it makes sense that if Ritalin worked then find a way to keep it working. The one and only med I know of with that potential is Memantine. I might not have mentioned it except that the few stories I've heard about it combined with stimulants were rather spectacular. Compared to maois, other cocktails, or whatever route you might go, Memantine is benign in comparison and when it works it does so fairly quickly.
You really should take a look at Memantine. Most doctors are not yet fully aware of its potentials, other than treating Alzheimers.
Posted by eric wagner on July 29, 2008, at 17:25:14
In reply to Re: Full trial of Panate w/ no response?, posted by bleauberry on July 28, 2008, at 20:25:14
> >
> > Daytrana (Methylphenidate) produced a response on all of the above, although short lived, so hopefully it's possible for another medication to produce the same
> >
>
> Too bad Memantine isn't better known. There have been some striking miraculous stories, even right here at pbabble, of people waking from the dead when Memantine was added to their meds, mostly based around stimulants like Ritalin or Modafinil.
>
> Memantine has shown anecdotal evidence of preventing and reversing the poopout/tolerance of Ritalin, allowing Ritalin to keep on working and at a lower dose. No way to predict if it would work with you or not, but it makes sense that if Ritalin worked then find a way to keep it working. The one and only med I know of with that potential is Memantine. I might not have mentioned it except that the few stories I've heard about it combined with stimulants were rather spectacular. Compared to maois, other cocktails, or whatever route you might go, Memantine is benign in comparison and when it works it does so fairly quickly.
>
> You really should take a look at Memantine. Most doctors are not yet fully aware of its potentials, other than treating Alzheimers.
>
>
>
>Do you happen to know the method by which Memantine produces the desired results when combined w/ a stimulant (methylphenidate)?
Possibly I can try to explain this to my less-than-up-on-new-combinations Psychiatrist if/when necessary.
Thank You & Be Well,
Eric M. Wagner
Posted by bleauberry on July 29, 2008, at 21:41:04
In reply to Re: Full trial of Panate w/ no response?, posted by eric wagner on July 29, 2008, at 17:25:14
The method was explained here, but was over my head. Try typing Memantine in the search box to bring up previous threads. A search of the archives should allow you to find the info. It also goes by the name Namenda. I believe this was maybe 2 months ago? Somewhere in that range. I can't remember if it was on this board or on the Neurotransmitter board.
Posted by Zeba on July 31, 2008, at 22:45:15
In reply to Full trial of Panate w/ no response?, posted by eric wagner on July 27, 2008, at 17:13:17
I just recently had to back off of 40 mg. of Parnate because I felt like I had ants under my skin in my ankles especially and could not keep my feet still. Has anyone had that reaction before. I am now down to 20 mg. per day from 40 mg. and worry that I am going to get really depressed again. After three days of this I still feel like I have ants under my skin in the frong of my ankle area. What is this???
Zeba
Posted by RICE on August 1, 2008, at 14:16:06
In reply to Full trial of Panate w/ no response?, posted by eric wagner on July 27, 2008, at 17:13:17
Look up "Dr. Jay Amsterdam". He used high dose parnate (90mg-170mg) on a group of MAOI non-responders, and they all reacted positively. It worked for me, but be careful!
This is the end of the thread.
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