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Dr. Bob is Robert Hsiung, MD,
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Posted by sigismund on January 5, 2012, at 3:40:21
In reply to Re: Adding Parnate and prazosin. » Bob, posted by SLS on January 5, 2012, at 3:26:11
And there is the fact that you have been on this combo minus the prozasin and gave it up. Maybe it is not exactly the same combo? You have been on and off .Parnate a few times that I can recall.
So, OK, a failed (?) blood pressure med has at last given you relief. Do you feel this is mediated through improved sleep? It doesn't sound like it from what you say.
I would like to try it for sleep improvement. I often don't get to the stage of sleep where nightmares are possible. I guess for me it is either this or trimiprimine
Posted by sigismund on January 5, 2012, at 3:44:08
In reply to Re: Adding Parnate and prazosin. » SLS, posted by sigismund on January 5, 2012, at 3:40:21
>So, OK, a failed (?) blood pressure med has at last given you relief.
And yet you speak/spoke about being slowed down and half dead rather than jumping out of your skin (as you might expect from someone who gains benefit from prozasin?).
I don't understand any of this of course.
Posted by SLS on January 5, 2012, at 4:13:22
In reply to Re: Adding Parnate and prazosin. » SLS, posted by sigismund on January 5, 2012, at 3:40:21
> And there is the fact that you have been on this combo minus the prozasin and gave it up. Maybe it is not exactly the same combo? You have been on and off .Parnate a few times that I can recall.
There are two differences with my Parnate treatment this time. I am taking lithium 300 mg and prazosin 6 mg. This is why I discontinued the prazosin as an experiment. I relapsed within 36 hours of discontinuation and recovered within a few hours of reinstatement.
> So, OK, a failed (?) blood pressure med has at last given you relief. Do you feel this is mediated through improved sleep?
I don't think so. I have a tendency to oversleep when I am at my baseline depression. I never had a sleep study, so I don't know what my EEG looks like.
> It doesn't sound like it from what you say.
>
> I would like to try it for sleep improvement. I often don't get to the stage of sleep where nightmares are possible. I guess for me it is either this or trimiprimineYour thinking is sharp and well-targeted.
Have you tried nefazodone? I believe it improves sleep architecture.
- Scott
Posted by SLS on January 5, 2012, at 4:16:13
In reply to Re: Adding Parnate and prazosin., posted by sigismund on January 5, 2012, at 3:44:08
Subject: NE alpha-1 receptors in cingulate.
It occurred to me that prazosin might quiet those neurons that are observed to be hyperactive in cingulate cortex (Brodmann areas 24, 25) in indviduals with MDD. If so, it would effectively mimic DBS.
This is a wild guess for which I have little supportive evidence.
- Scott
Posted by SLS on January 5, 2012, at 4:21:00
In reply to Re: Adding Parnate and prazosin., posted by sigismund on January 5, 2012, at 3:44:08
> >So, OK, a failed (?) blood pressure med has at last given you relief.
>
> And yet you speak/spoke about being slowed down and half dead rather than jumping out of your skin (as you might expect from someone who gains benefit from prozasin?).
>
> I don't understand any of this of course.
Have you had psychological traumas early in life?Is it possible that there is a PTSD component to your condition?
How is your memory? Is it impaired? If so, something might have beat the hell out of your hippocampus - extreme stress.
- Scott
Posted by g_g_g_unit on January 5, 2012, at 6:22:46
In reply to Re: Adding Parnate and prazosin., posted by SLS on January 5, 2012, at 4:13:22
I genuinely pray you see continued success on this combination, SLS! I hope I don't sound disingenuous, but I've always found your struggle heartbreaking.
So do you think prazosin could you be used to treat MAOI insomnia?
Posted by SLS on January 5, 2012, at 7:48:02
In reply to Re: Adding Parnate and prazosin. » SLS, posted by g_g_g_unit on January 5, 2012, at 6:22:46
> I genuinely pray you see continued success on this combination, SLS! I hope I don't sound disingenuous, but I've always found your struggle heartbreaking.
That is EXTREMELY affirming. Thank you.
> So do you think prazosin could you be used to treat MAOI insomnia?I never thought of that. I am not sure, but I doubt it. I didn't sleep at all last night due to drinking too much Diet Coke. I think I am now too sensitive to caffeine.
Maybe prazosin would help stress or anxiety induced insomnia. It works very well for PTSD sleep disturbances and nightmares.
The two things that I can recommend for MAOI-induced insomnia is the combining of two BZD receptor agonists or low-dose Seroquel. I like the idea of combining Sonata with Ativan or Restoril.
- Scott
Posted by sigismund on January 5, 2012, at 12:11:40
In reply to Re: Adding Parnate and prazosin. » sigismund, posted by SLS on January 5, 2012, at 4:21:00
>Have you had psychological traumas early in life?
Yes. I guess so. I came out of childhood frightened.
My memory now is impaired, but that is an age thing.
Posted by sigismund on January 5, 2012, at 15:16:44
In reply to Re: Adding Parnate and prazosin. » sigismund, posted by SLS on January 5, 2012, at 4:21:00
I don't know what the situation is here, but in some places nefazodone was discontinued because of liver toxicity?
Agomelatine too is toxic to the liver. I don't know how toxic. Just from the taste you can tell it is likely to be bad. We are not meant to eat things that taste so acrid. As soon as my stomach absorbed it my sinuses filled with mucous. It was good at first with sleep. I loved it.
Posted by SLS on January 5, 2012, at 15:17:03
In reply to Re: Adding Parnate and prazosin. » SLS, posted by sigismund on January 5, 2012, at 12:11:40
> >Have you had psychological traumas early in life?
> Yes. I guess so. I came out of childhood frightened.
Me, too. The world was simply too big for me.
- Scott
Posted by SLS on January 5, 2012, at 15:24:35
In reply to Re: Adding Parnate and prazosin., posted by sigismund on January 5, 2012, at 15:16:44
> I don't know what the situation is here, but in some places nefazodone was discontinued because of liver toxicity?
I read that the incidence of liver toxicity was fairly low. 1 in every 250,000. You could screen for toxicity with blood tests.
A friend of mine who has N24 circadian rhythm disorder finds prazosin helpful.
- Scott
Posted by Phillipa on January 5, 2012, at 18:38:53
In reply to Re: Adding Parnate and prazosin. » sigismund, posted by SLS on January 5, 2012, at 15:24:35
And to think I read on here about the liver toxicity and the banning in Canada and Europe so would not take it when the pdoc here begged me too. Others here basically said don't. As for nightmares for last two years having them frequently. Fears of death and things haven't thought about in years. I think the 40 year old female across the road from me takes it for PTSD nightmare also said it works for her. She's on other meds also antipsycotic, antidepressant? Jan/P
Posted by SLS on January 6, 2012, at 6:35:38
In reply to Re: Adding Parnate and prazosin. » SLS, posted by Phillipa on January 5, 2012, at 18:38:53
I am not feeling as well today as I had been feeling for the week before.
I am, of course, frightened.
Hopefully, I am not plateauing or relapsing.
I am being hypervigilant, I know.
30 years of failed treatments...
I don't want to go back there.
- Scott
Posted by Phillipa on January 6, 2012, at 19:47:18
In reply to Re: Adding Parnate and prazosin., posted by SLS on January 6, 2012, at 6:35:38
From your current regimen or did you cut down on abilify if so quality of life first? Jan/P
Posted by SLS on January 9, 2012, at 18:53:54
In reply to Re: Adding Parnate and prazosin. » SLS, posted by Phillipa on January 6, 2012, at 19:47:18
Still feeling better.
- Scott
Posted by Phillipa on January 9, 2012, at 20:25:54
In reply to Re: Adding Parnate and prazosin., posted by SLS on January 9, 2012, at 18:53:54
That is serious good mood as if can discontinue the abilify you will also lower triglycerides and weight and feel like lifting again maybe? Congrats so far. Phillipa
Posted by Beckett on January 9, 2012, at 23:56:22
In reply to Re: Adding Parnate and prazosin., posted by SLS on January 9, 2012, at 18:53:54
> Still feeling better.
>
>
> - ScottYou are ?
:-)
Posted by SLS on January 10, 2012, at 6:11:37
In reply to Re: Adding Parnate and prazosin. » SLS, posted by Phillipa on January 9, 2012, at 20:25:54
> That is serious good mood
Yup. Seriously good.
> as if can discontinue the abilify
I suspect that I can. I discontinued it for a few months in 2010, and was okay. I went back to it when I had a few bad days. Perhaps I was premature in restarting it. We'll see. If I must take Abilify, I will. I would rather live a few less years than to live out the rest of my days depressed.
> feel like lifting again maybe?
I really hope so. Exercise is something that I would like to add back in my life.
> Congrats so far.
Thanks. My doctor deserves the congratulations. His choice of prazosin was brilliant.
- Scott
Posted by SLS on January 10, 2012, at 6:15:10
In reply to Re: Adding Parnate and prazosin., posted by Beckett on January 9, 2012, at 23:56:22
> > Still feeling better.
> >
> >
> > - Scott> You are ?
I know. What a weird concept. It is too good to be true. I have a long way to go in terms of magnitude of improvement, but I remain optimistic. If I can get 50% better, I think I can return to employment.
> :-)
:-)
- Scott
Posted by Bob on January 10, 2012, at 14:17:38
In reply to Re: Adding Parnate and prazosin. » Beckett, posted by SLS on January 10, 2012, at 6:15:10
> > > Still feeling better.
> > >
> > >
> > > - Scott
>
> > You are ?
>
> I know. What a weird concept. It is too good to be true. I have a long way to go in terms of magnitude of improvement, but I remain optimistic. If I can get 50% better, I think I can return to employment.
>
> > :-)
>
> :-)
>
>
> - Scott
I'm still a little confused. You started the Parnate at the same time as the Prazosin, right? How do you know you're positive response is not due to a combination of Parnate + Prazosin, or Prazosin + one of the other drugs in your cocktail (e.g. Abilify), or Parnate + Abilify, etc...?Bob
Posted by SLS on January 10, 2012, at 14:42:42
In reply to Re: Adding Parnate and prazosin. » SLS, posted by Bob on January 10, 2012, at 14:17:38
Hi Bob.
> > > > Still feeling better.
> > > >
> > > >
> > > > - Scott
> >
> > > You are ?
> >
> > I know. What a weird concept. It is too good to be true. I have a long way to go in terms of magnitude of improvement, but I remain optimistic. If I can get 50% better, I think I can return to employment.
> >
> > > :-)
> >
> > :-)
> >
> >
> > - Scott
>
>
> I'm still a little confused. You started the Parnate at the same time as the Prazosin, right? How do you know you're positive response is not due to a combination of Parnate + Prazosin, or Prazosin + one of the other drugs in your cocktail (e.g. Abilify), or Parnate + Abilify, etc...?
>
> Bob
I began prazosin 2 weeks before I began taking Parnate. I felt somewhat improved during this time, although the improvement was subtle. I responded significantly well to the addition of Parnate within 10 days of starting it at a dosage of 60 mg. I then discontinued the prazosin for 36 hours as an experiment. I relapsed, and then added it back.I am hoping that I can discontinue Abilify without relapsing. I am down to 5.0 mg. The next step is to take 5.0 mg every other day. So far, I have not observed any deterioration in my condition.
- Scott
Posted by Bob on January 10, 2012, at 14:46:53
In reply to Re: Adding Parnate and prazosin. » Bob, posted by SLS on January 10, 2012, at 14:42:42
> Hi Bob.
>
> > > > > Still feeling better.
> > > > >
> > > > >
> > > > > - Scott
> > >
> > > > You are ?
> > >
> > > I know. What a weird concept. It is too good to be true. I have a long way to go in terms of magnitude of improvement, but I remain optimistic. If I can get 50% better, I think I can return to employment.
> > >
> > > > :-)
> > >
> > > :-)
> > >
> > >
> > > - Scott
> >
> >
> > I'm still a little confused. You started the Parnate at the same time as the Prazosin, right? How do you know you're positive response is not due to a combination of Parnate + Prazosin, or Prazosin + one of the other drugs in your cocktail (e.g. Abilify), or Parnate + Abilify, etc...?
> >
> > Bob
>
>
> I began prazosin 2 weeks before I began taking Parnate. I felt somewhat improved during this time, although the improvement was subtle. I responded significantly well to the addition of Parnate within 10 days of starting it at a dosage of 60 mg. I then discontinued the prazosin for 36 hours as an experiment. I relapsed, and then added it back.
>
> I am hoping that I can discontinue Abilify without relapsing. I am down to 5.0 mg. The next step is to take 5.0 mg every other day. So far, I have not observed any deterioration in my condition.
>
>
> - Scott
So it sounds like having the Parnate on board helped at least a little?
Posted by SLS on January 10, 2012, at 15:09:29
In reply to Re: Adding Parnate and prazosin. » SLS, posted by Bob on January 10, 2012, at 14:46:53
> > I began prazosin 2 weeks before I began taking Parnate. I felt somewhat improved during this time, although the improvement was subtle. I responded significantly well to the addition of Parnate within 10 days of starting it at a dosage of 60 mg. I then discontinued the prazosin for 36 hours as an experiment. I relapsed, and then added it back.
> >
> > I am hoping that I can discontinue Abilify without relapsing. I am down to 5.0 mg. The next step is to take 5.0 mg every other day. So far, I have not observed any deterioration in my condition.> So it sounds like having the Parnate on board
helped at least a little?I would say that the Parnate is an important component to my treatment. I seem to need a MAOI and TCA in combination. This is what I had success with in the past.
- Scott
Posted by Phillipa on January 10, 2012, at 18:38:25
In reply to Re: Adding Parnate and prazosin. » Bob, posted by SLS on January 10, 2012, at 15:09:29
Scott just what if you only needed the prazosin? And not a technical depression med? Is it possible that after all this time you have been taking meds that have hampered your recovery instead of helping. Just a wild thought out of nowhere. And it was your doc's suggestion? Your doc is great!!!! Phillipa
Posted by SLS on January 13, 2012, at 5:28:24
In reply to Re: Adding Parnate and prazosin. » SLS, posted by Phillipa on January 10, 2012, at 18:38:25
Hi All.
Well, I am still improved, but I am impatient to feel MUCH better. I worry that this will be only a partial response or a fading response. It is not happening fast enough for me to feel confident that this will be the end to my suffering.
My advice to myself is to take it week by week or month by month, but not day by day. That's what I tell other people. It is so hard, though.
I want a guarantee.
- Scott
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Dr. Bob is Robert Hsiung, MD,
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