Posted by ed_uk2010 on October 22, 2013, at 16:28:24
In reply to Re: Parnate - raise or augment? » jono_in_adelaide, posted by tensor on October 21, 2013, at 5:27:02
Hi M,
I believe you're taking 20mg of tranyl twice a day, is that right? Since you appear to be experiencing 'ups' and 'downs' during the day as your Parnate blood level rises and falls, I'd be very tempted to spread your total daily dose out into a greater number of divided doses - this could be inconvenient but possibly very worthwhile. For example, you could increase to 50mg by taking 20mg in the morning then 10mg three times a day. This could lead to greater stability, with the melatonin continuing to improve your insomnia. I do think augmentation is a definite possibility, but it might be worth experimenting with Parnate alone for a couple more weeks first.
The hives are too mild and intermittent to represent a true allergy, but cetirizine 10mg/day could be a good choice to deal with this. I expect you can buy it from a pharmacy - certainly, you can in most countries, and it's a very safe and well tolerated drug. I do not believe that you're any more likely to experience the dreaded rash with Lamictal because of this reaction, but you could be misled into thinking you're developing a serious Lamictal rash when you're actually experiencing something much more minor. Confusing :(
If you're considering adding back a bit of quetiapine, start really low and increase very gradually. The risk of hypotension seems to be much reduced by this method. For example, try 12.5mg at night to start with.
Best regards,
Ed :)
PS. And finally, don't forget that some people get a much better AD effect from Nardil than Parnate. If Parnate doesn't work out, Nardil could be a fantastic choice.
poster:ed_uk2010
thread:1052459
URL: http://www.dr-bob.org/babble/20130930/msgs/1052804.html