Posted by Robert_Burton_1621 on March 8, 2015, at 6:53:48
In reply to Re: Progress on Parnate - Four-week point » Robert_Burton_1621, posted by ed_uk2010 on March 5, 2015, at 15:02:36
> HI Robert,
Hi Ed, I hope you are going well. I am very pleased, as usual, to read your response. Thanks indeed.
> Perhaps you'll be able to stop it soon?
That is the aim; I will see how the itching goes. The cetirizine is definitely becoming less necessary.
> >Parnate has been the most side-effect minimal medication I have ever taken.
>
> That's interesting. You did appear to have adverse effects initially, but they have worn off. Good news.
>Yes, you're right about the initial side-effects, but even those weren't as troubling as some of the side-effects I had with SSRIs and SNRIs. But I may have spoken too soon!
I am experiencing pretty profound weakness again at various times during the day and night. My appetite has improved considerably, so it's not owing to a lack of callories. The weakness is both physical and mental. I have been taking my BP everyday, and there is no clear sign at all of postural hypotension within the three minute period (today's result was: sitting = 124/76; immediate standing = 118/75; three minute standing = 121/83).
But my BP is lowering at various points to systolic 105-110 and I can't figure out why.
I have been taking ibuprofen 3 x 200mg over the last four days because of an inflammed throat, but stopped today to exclude it as a possible cause (though I am aware that it should raise BP).
> >I took my most recent self-assessment on 27/2 and scored HDRS= 23 and MADRS = 25. Those scores can be described as nothing other than improvements
>
> I'm delighted to hear of your progress, even though there's still a way to go. It's great to hear you've been back to the gym. I should really go myself.
>Thanks, Ed. This week the gym, because of my weakness, was a real challenge and I just had to stop. But the breathing and core work is beneficia. I probably wouldn't go if I didn't have an understanding and attentive PT. He's very good.
> >I decided to go down because I do not wish to push the boundaries with my doctor.
>
> Has your doctor expressed any opinions on how high the dosage should be pushed, if necessary?
>No, none, but that's because the first I will see him since starting is this Thursday. His advice was to titrate up to 40mg until I see him again, but I pushed it beyond. At the moment I'm taking 50mg in the morning on waking up, and 20mg at about noon. I am going very well in the mornings. And my sleep has been (touch wood!) excellent. It seems I have adapted into a pattern, so I am able to sleep at about 12 midnight and get up at 6:30 - 7:30 am *consistently*! This is a major turn around for me, since mornings had always been, for close to two decades, extremely challenging. Before this change, I cannot recall that last time I have been able to wake up at 7:30 say for two days in a row, let alone regularly for a week.
> It is not clear what the maximum dose should be. I suggest doing a full blood count (including a platelet count) every couple of months if titration to a higher dose is planned. A reduced platelet count ie. thrombocytopaenia (with occasional bleeding/bruising) is one of the major toxic effects reported from very high doses.
Thanks for this heads-up. I will raise this with my doctor on Thursday.
poster:Robert_Burton_1621
thread:1075968
URL: http://www.dr-bob.org/babble/20150223/msgs/1077378.html