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Dr. Bob is Robert Hsiung, MD,
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Posted by Quintal on August 31, 2008, at 12:04:21
In reply to Re: Best way to take Parnate? » Quintal, posted by john51 on August 31, 2008, at 10:30:46
My pdoc would only prescribe 30mg as that's the upper recommended limit for Parnate here. I'm not a very obedient person... in the end I had to come off it because I kept running out and the dose he was willing to give me only made me feel worse. I hope your pdoc is more sympathetic than mine. I can't guanruntee that higher doses will be any different for you, but I hope you can give them a try before switching to something else. It's a very effective drug, when it works.
Q
Posted by john51 on August 31, 2008, at 12:47:52
In reply to Re: Best way to take Parnate? » john51, posted by Quintal on August 31, 2008, at 12:04:21
> My pdoc would only prescribe 30mg as that's the upper recommended limit for Parnate here. I'm not a very obedient person... in the end I had to come off it because I kept running out and the dose he was willing to give me only made me feel worse. I hope your pdoc is more sympathetic than mine. I can't guanruntee that higher doses will be any different for you, but I hope you can give them a try before switching to something else. It's a very effective drug, when it works.
>
> Q
I don't think that I could describe my pdoc as sympathetic. In fact, because I would not go for ECT treatment he told me that he wouldn't treat me any longer. It took a call from another doctor that wasn't comfortable prescribing Parnate (or any MAOI) to get him to "take me back". I do think he will be willing to raise the dosage above 30mg, possibly up to 60, but he doesn't have me scheduled to return for an entire month. I can't imagine feeling this way for a whole month!!john
Posted by Quintal on August 31, 2008, at 13:33:47
In reply to Re: Best way to take Parnate? » Quintal, posted by john51 on August 31, 2008, at 12:47:52
>In fact, because I would not go for ECT treatment he told me that he wouldn't treat me any longer.
That is awful.
Parnate made me very unwell during the first week or so, so I understand what you're going through. Can you call his office and ask for an emergency appointment?
Q
Posted by john51 on August 31, 2008, at 16:06:44
In reply to Re: Best way to take Parnate?, posted by Quintal on August 31, 2008, at 13:33:47
> >In fact, because I would not go for ECT treatment he told me that he wouldn't treat me any longer.
>
> That is awful.
>
> Parnate made me very unwell during the first week or so, so I understand what you're going through. Can you call his office and ask for an emergency appointment?
>
> QOh, I suppose that I could call and ask for an emergency appointment but I really hesitate because this doctor actually intimidates me..makes me feel defensive....makes me feel like a fool...I swear, I have never met another pdoc like him. When I am in his office, he doesn't even look at me he never asks me about my depression and how it manifests itself. I am afraid that if I called it would only irritate him. I know that this is NOT the way things should be...but he is the only pdoc that I know of that is willing to prescribe MAOIs....and I felt that I needed to try an MAOI again because years ago I did have some success with Nardil...but Nardil is different now (there's a whole web community about it) and the last time I tried it, it didn't work. So..I thought I would try Parnate....
I wish this could all be over...I wish I could just be normal and handle my life without these problems!!
john
Posted by Quintal on August 31, 2008, at 16:26:07
In reply to Re: Best way to take Parnate? » Quintal, posted by john51 on August 31, 2008, at 16:06:44
That sounds pretty much like my last pdoc. I'm still sure he's the closest thing to high functioning psychopath I've ever encountered! I always left feeling like a peice of sh*t he just wiped off his shoe. I don't know what to say because there doesn't seem an easy way out of that. I feel your pain. I only hope Parnate turns round and starts working for you at this lower dose.
Q
Posted by john51 on August 31, 2008, at 16:30:13
In reply to Re: Best way to take Parnate? » john51, posted by Quintal on August 31, 2008, at 16:26:07
> That sounds pretty much like my last pdoc. I'm still sure he's the closest thing to high functioning psychopath I've ever encountered! I always left feeling like a peice of sh*t he just wiped off his shoe. I don't know what to say because there doesn't seem an easy way out of that. I feel your pain. I only hope Parnate turns round and starts working for you at this lower dose.
>
> Q
You described the experience better than I did...that is how I feel after I see this doctor. I think that he has so much business that he could care less about one individual!!Thanks Q!
Posted by Nadezda on August 31, 2008, at 17:59:47
In reply to Re: Best way to take Parnate? » Quintal, posted by john51 on August 31, 2008, at 16:30:13
Good grief! Get a new pdoc. That sounds awful.
Parnate totally knocked me out, too. I don't think I got anything resembling a serious AD effect until I hit about 80 mg a day. At lower doses, I was so exhausted I didn't feel so bad- probably just never more than semi-awake. But I never really had much energy on the stuff. It was noticably better at higher doses-- I didn't fall asleep every few hours, for an hour or so-- but I never had anything like full alertness either.
The AD effect was enough to keep me on it-- at my Ts and friends' insistance-- but it was pretty awful.
I hope it works a lot better for you. But still, isn't there anyone in your area who prescribes Maois except this guy? Couldn't he consult with someone else, whom you could use as your primary pdoc. A pdoc who insists on ECT is dangerous.
Nadezda
Posted by john51 on August 31, 2008, at 19:29:43
In reply to Re: Best way to take Parnate? » john51, posted by Nadezda on August 31, 2008, at 17:59:47
> Good grief! Get a new pdoc. That sounds awful.
>
> Parnate totally knocked me out, too. I don't think I got anything resembling a serious AD effect until I hit about 80 mg a day. At lower doses, I was so exhausted I didn't feel so bad- probably just never more than semi-awake. But I never really had much energy on the stuff. It was noticably better at higher doses-- I didn't fall asleep every few hours, for an hour or so-- but I never had anything like full alertness either.
>
> The AD effect was enough to keep me on it-- at my Ts and friends' insistance-- but it was pretty awful.
>
> I hope it works a lot better for you. But still, isn't there anyone in your area who prescribes Maois except this guy? Couldn't he consult with someone else, whom you could use as your primary pdoc. A pdoc who insists on ECT is dangerous.
>
> NadezdaThank you for your reply Nadezda!
Believe me, if I can find a new pdoc, I WILL!!
I realize that if I can hang in there long enough to reach a therapeutic dose on the Parnate it could work and end up being worth it...I just don't know if I can stand feeling this weak and exhausted and "out of it" for that long!!
John
Posted by djmmm on August 31, 2008, at 19:42:22
In reply to Best way to take Parnate?, posted by john51 on August 29, 2008, at 15:01:19
> I just started taking Parnate. My pscript is for 10mg 3 times a day. I have read and heard that Parnate can cause insomnia and that is the last thing that I want to happen. So, normally I would take a 3 a day med every 6-8 hours thinking about the most "even" distribution of the med in my system...right? But, because I don't want to experience insomnia, which I already have problems with and don't want it to get worse, I am wondering what other people taking Parnate do and how important it is to "evenly" spread out the 3 a day dosage.
I take 20mg in the morning (6 or 7am) and another 30mg at noon...I have found that your body will pretty much adjust to any dosage schedule over time. I think most people agree that you should not take it in the evening.
Posted by eric wagner on August 31, 2008, at 22:49:10
In reply to Re: Best way to take Parnate? » Quintal, posted by john51 on August 31, 2008, at 16:06:44
> > >In fact, because I would not go for ECT treatment he told me that he wouldn't treat me any longer.
> >
> > That is awful.
> >
> > Parnate made me very unwell during the first week or so, so I understand what you're going through. Can you call his office and ask for an emergency appointment?
> >
> > Q
>
> Oh, I suppose that I could call and ask for an emergency appointment but I really hesitate because this doctor actually intimidates me..makes me feel defensive....makes me feel like a fool...I swear, I have never met another pdoc like him. When I am in his office, he doesn't even look at me he never asks me about my depression and how it manifests itself. I am afraid that if I called it would only irritate him. I know that this is NOT the way things should be...but he is the only pdoc that I know of that is willing to prescribe MAOIs....and I felt that I needed to try an MAOI again because years ago I did have some success with Nardil...but Nardil is different now (there's a whole web community about it) and the last time I tried it, it didn't work. So..I thought I would try Parnate....
>
> I wish this could all be over...I wish I could just be normal and handle my life without these problems!!
>
> john
>I am really scared what I might do to my PDoc b/c of the same issues.
I'm still young & stupid
Posted by eric wagner on August 31, 2008, at 22:52:10
In reply to Re: Best way to take Parnate? » john51, posted by Nadezda on August 31, 2008, at 17:59:47
> Good grief! Get a new pdoc. That sounds awful.
>
> Parnate totally knocked me out, too. I don't think I got anything resembling a serious AD effect until I hit about 80 mg a day. At lower doses, I was so exhausted I didn't feel so bad- probably just never more than semi-awake. But I never really had much energy on the stuff. It was noticably better at higher doses-- I didn't fall asleep every few hours, for an hour or so-- but I never had anything like full alertness either.
>
> The AD effect was enough to keep me on it-- at my Ts and friends' insistance-- but it was pretty awful.
>
> I hope it works a lot better for you. But still, isn't there anyone in your area who prescribes Maois except this guy? Couldn't he consult with someone else, whom you could use as your primary pdoc. A pdoc who insists on ECT is dangerous.
>
> NadezdaPeople like me have been to every PDoc in the area
Wish it was as easy as switching Dr's.
Think Before You Speak
Posted by Nadezda on September 1, 2008, at 0:25:39
In reply to Re: Best way to take Parnate? » Nadezda, posted by eric wagner on August 31, 2008, at 22:52:10
Where do live?
Is there a larger metropolitan area anywhere in the vicinity? Maybe if you're not having any luck where you live, you could explore a little further away from home.
Nadezda
Posted by john51 on September 1, 2008, at 8:16:34
In reply to Re: Best way to take Parnate? » eric wagner, posted by Nadezda on September 1, 2008, at 0:25:39
> Where do live?
>
> Is there a larger metropolitan area anywhere in the vicinity? Maybe if you're not having any luck where you live, you could explore a little further away from home.
>
> NadezdaI live in Central Upstate NY....the closest "metropolitan" area is Syracuse which is about 40 miles from me and that is where my current pdoc is. There is a State University Hospital there and I did go to their adult psych outpatient clinic for quite a while but there you see a Resident Doc and when their residency is up you get switched to another one...
I wish I lived closer to NYC or Boston. Boston has the McLean Hospital which is supposed to be one of the BEST places for mood disorders.
Posted by john51 on September 2, 2008, at 17:11:53
In reply to Re: Best way to take Parnate? » Nadezda, posted by john51 on September 1, 2008, at 8:16:34
Just wanted to let you all know that I stopped the Parnate yesterday. I simply could not stand the way it was making me feel. Now I don't know what to do next. I am totally depressed and miserasble and yet I feel very anxious all at the same time. I am also worried about what my pdoc is going to say when I tell him that I stopped.
I just wish there was something I could do to feel better.
Posted by mav27 on September 2, 2008, at 20:17:28
In reply to Re: Best way to take Parnate?, posted by john51 on September 2, 2008, at 17:11:53
have you tried Nardil ?
> Just wanted to let you all know that I stopped the Parnate yesterday. I simply could not stand the way it was making me feel. Now I don't know what to do next. I am totally depressed and miserasble and yet I feel very anxious all at the same time. I am also worried about what my pdoc is going to say when I tell him that I stopped.
>
> I just wish there was something I could do to feel better.
Posted by john51 on September 2, 2008, at 20:48:02
In reply to Re: Best way to take Parnate? » john51, posted by mav27 on September 2, 2008, at 20:17:28
Actually, it was because I had success with Nardil that I decided to try Parnate. That success was about 16 years ago. I did try Nardil again about 3 years ago (after it had been reformulated) and it didn't seem to work like it did before. Many people have also said that the "new" Nardil doesn't work anywhere near as good as the original. I'm not trying to just discount it I just don't know what on earth to do at this point.....
> have you tried Nardil ?
>
> > Just wanted to let you all know that I stopped the Parnate yesterday. I simply could not stand the way it was making me feel. Now I don't know what to do next. I am totally depressed and miserasble and yet I feel very anxious all at the same time. I am also worried about what my pdoc is going to say when I tell him that I stopped.
> >
> > I just wish there was something I could do to feel better.
>
>
Posted by Nadezda on September 2, 2008, at 22:46:27
In reply to Re: Best way to take Parnate?, posted by john51 on September 2, 2008, at 20:48:02
You could also try Emsam, which doesn't have the food restrictions and is transdermal.
Or how about Nardil with something to boost the effect?
Nadezda
Posted by softheprairie on September 2, 2008, at 23:19:50
In reply to Re: Best way to take Parnate? » john51, posted by Nadezda on September 2, 2008, at 22:46:27
> You could also try Emsam, which doesn't have the food restrictions and is transdermal.
>Officially, the lack of food restrictions on EMSAM is only at the first/lowest dose.
Maybe Marplan? I would expect a pharmacy wouldn't have it on hand, but would have to order it. And...I sort of can't believe I'm actually saying this, but since you feel so utterly cr@ppy, perhaps Zyprexa just to tide you over until a main antidepressant has time to take effect. (And I even say that as someone with diabetes, which Zyprexa can cause.)
Posted by Nadezda on September 3, 2008, at 10:43:32
In reply to Re: Best way to take Parnate?, posted by softheprairie on September 2, 2008, at 23:19:50
Officially, the food restrictions are only lifted at the lower dose, but unofficially, if you read the original petitions and FDA response, there's a lot of evidence that the food restrictions aren't necessary at higher doses, too.
I'm not saying that it's safe to do that-- but I think it's certainly worth experimenting cautiously with your response, after you're well stabilized Emsam. Or asking your pdoc about his/her view about it.
The original application was for no food restrictions on higher doses, and the drug company compromised with the FDA in order to get the drug out right away. I wonder if Somerset or Squib has done any further studies on the question.
Nadezda
Posted by Justherself54 on September 3, 2008, at 19:38:12
In reply to Re: Best way to take Parnate?, posted by john51 on September 2, 2008, at 17:11:53
> Just wanted to let you all know that I stopped the Parnate yesterday. I simply could not stand the way it was making me feel. Now I don't know what to do next. I am totally depressed and miserasble and yet I feel very anxious all at the same time. I am also worried about what my pdoc is going to say when I tell him that I stopped.
>
> I just wish there was something I could do to feel better.Can you take a benzo to help with the anxiety?
Did you just stop the Parnate cold turkey? If so, how are you feeling? I'm down to 30 mg and feel pretty horrible. Depressed, anxious, no appetite. If I knew it was just a couple of days, I would be tempted to take extra clonazapam and cold turkey it too. Let me know how you're doing. Take care.
PS, my pdoc doesn't know I'm going off it either but he knows I have had very little response to it, so I don't think he'll be too surprised.
Posted by softheprairie on September 3, 2008, at 20:22:15
In reply to Re: Best way to take Parnate? » softheprairie, posted by Nadezda on September 3, 2008, at 10:43:32
> Officially, the food restrictions are only lifted at the lower dose, but unofficially, if you read the original petitions and FDA response, there's a lot of evidence that the food restrictions aren't necessary at higher doses, too.
>
> I'm not saying that it's safe to do that-- but I think it's certainly worth experimenting cautiously with your response, after you're well stabilized Emsam. Or asking your pdoc about his/her view about it.
>
> The original application was for no food restrictions on higher doses, and the drug company compromised with the FDA in order to get the drug out right away. I wonder if Somerset or Squib has done any further studies on the question.
>
> Nadezda
>
>Yes, I was partly aware of that when I took EMSAM, and I always got away with my mild cheating on the diet; I didn't know how much to get into it here, so I just put "officially."
But, I think it was here on Babble that I read of someone or a few people getting the hypertensive reaction while on EMSAM.Anyways, John, how are you? What are you (or your dr.) leaning towards taking next?
Posted by john51 on September 4, 2008, at 7:00:59
In reply to Re: Best way to take Parnate?, posted by Justherself54 on September 3, 2008, at 19:38:12
> > Just wanted to let you all know that I stopped the Parnate yesterday. I simply could not stand the way it was making me feel. Now I don't know what to do next. I am totally depressed and miserasble and yet I feel very anxious all at the same time. I am also worried about what my pdoc is going to say when I tell him that I stopped.
> >
> > I just wish there was something I could do to feel better.
>
>
>
> Can you take a benzo to help with the anxiety?
>
> Did you just stop the Parnate cold turkey? If so, how are you feeling? I'm down to 30 mg and feel pretty horrible. Depressed, anxious, no appetite. If I knew it was just a couple of days, I would be tempted to take extra clonazapam and cold turkey it too. Let me know how you're doing. Take care.
>
> PS, my pdoc doesn't know I'm going off it either but he knows I have had very little response to it, so I don't think he'll be too surprised.
>Okay, first of all I was only on the Parnate for 4 days (each one of them more miserable than the one before) at 30mg and YES I DID stop it cold turkey. Started feeling better (not better than my baseline, just not "destroyed" by the Parnate) the very first day without it. Today is day 4 w/o it. And, to answer your question I have been taking a benzo for a LONG TIME (clonazepam) and it helps somewhat with anxiety. My anxiety is more like an agitation....mixed with my depression.
Posted by john51 on September 4, 2008, at 7:12:10
In reply to Re: Best way to take Parnate?, posted by softheprairie on September 3, 2008, at 20:22:15
> > Officially, the food restrictions are only lifted at the lower dose, but unofficially, if you read the original petitions and FDA response, there's a lot of evidence that the food restrictions aren't necessary at higher doses, too.
> >
> > I'm not saying that it's safe to do that-- but I think it's certainly worth experimenting cautiously with your response, after you're well stabilized Emsam. Or asking your pdoc about his/her view about it.
> >
> > The original application was for no food restrictions on higher doses, and the drug company compromised with the FDA in order to get the drug out right away. I wonder if Somerset or Squib has done any further studies on the question.
> >
> > Nadezda
> >
> >
>
> Yes, I was partly aware of that when I took EMSAM, and I always got away with my mild cheating on the diet; I didn't know how much to get into it here, so I just put "officially."
> But, I think it was here on Babble that I read of someone or a few people getting the hypertensive reaction while on EMSAM.
>
> Anyways, John, how are you? What are you (or your dr.) leaning towards taking next?How am I? Not good! What am I (or my doc ) going to do next? I have NO IDEA!! I called my pdocs office Tuesday to tell him that I felt that I NEEDED to STOP the Parnate...he, of course was not there but his secretary said that he would call me the next day (yesterday).........
He never called!!! This is my WONDERFUL CARING PDOC!!!
Considering that he had RELUCTANLY agreed to take me back and treat me with the Parnate and then I stopped it after only 4 days, I am pretty sure that he is NOT going to be very sympathetic or helpful OR even willing to do anything more with me.
I went to a new therapist (PhD Psych) yesterday and we spent almost an hour filling out a form that: qoute "my lawyer drafted for me in case I get audited by Medicare, and I have been audited by Medicare". I felt like I was being interviewed by a detective. Then, with about 10-15 mintues left in the appointment he asked me, "Ok, where would you like to start?"
I don't know if there are ANY copmpetent therapists OR pdocs anywhere here in my area!!! By the way, I live between Utica and Syracuse, NY. This is the Central Upstate portion of the state.
Posted by Nadezda on September 4, 2008, at 10:33:06
In reply to Re: Best way to take Parnate?, posted by john51 on September 4, 2008, at 7:12:10
Have you tried looking in Ithaca?
The thing is, it can be hard to find a good pdoc anywhere, even where there are good ones around. There are many bad ones (at least that's been my experience) and it's so possible that you've had bad luck, but that there is someone else you haven't found. The problem is it's so hard to make the right connection.
I found my current pdoc through a recommendation. Is there anyone else you could ask?
Or maybe if you check some online journals you'll find someone in Syracuse or Ithaca who writes about research and you'll have names of people who know about Maois. Other than just keeping looking for a more sympathetic (but also knowledgeable) pdoc, I don't know what to suggest. I do think it's important to have someone you can trust, and rely on to be more caring. I hope you don't give up on the search.
Nadezda
Posted by softheprairie on September 4, 2008, at 17:30:44
In reply to Re: Best way to take Parnate?, posted by john51 on September 4, 2008, at 7:12:10
> >
> > Anyways, John, how are you? What are you (or your dr.) leaning towards taking next?
>
> How am I? Not good! What am I (or my doc ) going to do next? I have NO IDEA!! I called my pdocs office Tuesday to tell him that I felt that I NEEDED to STOP the Parnate...he, of course was not there but his secretary said that he would call me the next day (yesterday).........
>
> He never called!!! This is my WONDERFUL CARING PDOC!!!
>
> Considering that he had RELUCTANLY agreed to take me back and treat me with the Parnate and then I stopped it after only 4 days, I am pretty sure that he is NOT going to be very sympathetic or helpful OR even willing to do anything more with me.
>
> I went to a new therapist (PhD Psych) yesterday and we spent almost an hour filling out a form that: qoute "my lawyer drafted for me in case I get audited by Medicare, and I have been audited by Medicare". I felt like I was being interviewed by a detective. Then, with about 10-15 mintues left in the appointment he asked me, "Ok, where would you like to start?"
>
> I don't know if there are ANY copmpetent therapists OR pdocs anywhere here in my area!!! By the way, I live between Utica and Syracuse, NY. This is the Central Upstate portion of the state.
I thought I'd throw the names of two psychiatrists out whose book I have, even though it appears they're too far for you to drive to long-term -- Richard P. Brown and Patricia L. Gerbarg (they are a married couple). The dust jacket of their book says they live in upstate NY, her w/ a practice there and he w/ offices in both Manhattan and upstate. An online search showed her office in the town of Kingston, which looks kinda a far drive for you, and his C.V. just listed his NYC adrs. However, his C.V. does include publishing on MAOIs in the 1980s.They're into integrating conventional and alternative psychiatry. The book of theirs I have is about the herb rhodiola, called The Rhodiola Revolution. They both also have teaching appointments at medical schools. From the big achievements of their C.V.s I'd imagine they are expensive or hard to get apts. w/, but I don't know.
They sound personable in thier book, but then most people would!
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