Posted by bleauberry on March 18, 2009, at 15:38:09
In reply to Parnate Dissapointment :( But I sleep better. ??, posted by AdamCanada2 on March 18, 2009, at 11:11:40
Ya know, with the background of so many med failures, and now some forward movement finally, gosh I sure wish there was a way to finetune Parnate. There has to be. How, I don't know.
For one, go with the dose that is the best compromise. Is that 10mg? 15mg? Whatever it is, stay there. I don't know how long you've been on Parnate, but I think it needs a solid 3 months at a steady uninterrupted dose to really do its thing. The good things you feel now might just be hints of things around the corner.
Sleep is obviously the major issue. Risperdal seems like a decent option, between .25mg and .5mg. I wouldn't go any higher than that personally, on that particular med. Have you ever tried Zyprexa? It is a good sleep med, not the elephant dart that Seroquel is, but a smoother sleep, and the daytime zombieness the next day isn't nearly the degree of Seroquel. Why, I don't know. But that is just my experience. All I know is 25mg Seroquel completely zombied me out 24/7 while 2.5mg-5mg Zyprexa only did that at bedtime and maybe at waking, but that's it.
I think the sleep problems will gradually resolve over months, but you do need some sleep help now. Waiting months for good sleep is not an option.
Lunesta. Too bad you can't get that.
Though I'm a little stuck as exactly what to do, I think basically...get the dose down to what works better than your baseline misery, give it a few months, and continue working on sleep with other options such as Zyprexa. Perhaps Nortriptyline would be a good trial too. I'm not sure if Amitriptyline is safe with Parnate, but that would be one to ask your doc about.
I do not know which meds to suggest, but I was thinking something that is anti-cortisol and/or anti-norepinephrine. Not an NE antagonist like Remeron, because that will just stimulate more NE. I'm talking about blocking NE for about 8 hours for sleep. Some kind of alpha blocker of something. Maybe do some research on that?
I've tried Tianeptine and I seriously doubt it has the power to do what you want.
poster:bleauberry
thread:885917
URL: http://www.dr-bob.org/babble/20090313/msgs/885963.html