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Dr. Bob is Robert Hsiung, MD,
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Posted by g_g_g_unit on October 13, 2009, at 22:21:15
In reply to Re: Trazadone and Parnate » emmanuel98, posted by MAxime on October 13, 2009, at 22:12:56
> Seriously? Damn. I need sleep. Last night I didn't sleep AT ALL. And tonight it doesn't feel like I am going to sleep either. There must be somehing that I can take?
i don't want to recommend it but lots of people seem to take Trazodone regardless. maybe at low doses there isn't a danger? i mean in the literature TCA's are completely contraindicted too, but there are people using amitriptyline etc. with Parnate.
how did you sleep last time you were on it? was there a dose where you finally slept okay? i don't wanna give up, but this sleep thing sucks, i just guzzle down benzos
Posted by Phillipa on October 13, 2009, at 23:55:24
In reply to Re: Trazadone and Parnate, posted by g_g_g_unit on October 13, 2009, at 22:21:15
Oops was on trazadone and prozac sorry. Love Phillipa
Posted by Sunbath on October 14, 2009, at 6:43:04
In reply to Trazadone and Parnate, posted by Maxime on October 13, 2009, at 17:47:03
Hi Maxime!
Even regarding the manufacturer of Parnate in Germany it's possible to combine Parnate with trazodone (and with amitriptyline and other TCAs). BUT they say it's only recommended when you started the tca before or while you are starting Parnate.. not after. However some ppl also on babble, I think it's Scott, but please ask him yourself as I can't say for sure anymore, tried doing it the other way round (not amitriptyline I think but it might have been nortriptyline) and it worked without any problems.. I also tried adding ultra low dose amitriptyline (10-20mg) a few days before and it was no problem at all.. I think that might be because that's a really low dose.
Regarding trazodone: it's such a weak serotonin reuptake blocking agent, that it seems impossible to cause any serotonine syndrome except maybe in ultra high doses.. Its affinity for the SERT is about Ki 600 where's amitriptyline's affinity is about Ki 4 I think. So amitriptyline is soooo much more potent and even that is possible to combine with Parnate (at least when you watch out for the right order, i.e. starting it before beginning Parnate therapy).
It might well be that I don't get something, but isn't the only real danger when you are combining TCAs the possibility for serotonin syndrome? Then I can't understand why trazodone could be dangerous at all! I think it's just in the contraindicated list because it theoretical is a sri, but practicly it's just a 5ht2a/2c antagonist that helps with sleep :)
Well that's only my thoughts and I'm really not competent and of course no doctor.
But even my doctor -who never prescribed Parnate before and who is quite cautiously- allows me to take 200mg trazodone/night (but that's an extended release version!).Maybe your doctor would let you do it?
Good luck to you!!!! I really hope that it will work out for you this time!!!
Posted by emmanuel98 on October 14, 2009, at 11:54:35
In reply to Re: Trazadone and Parnate » emmanuel98, posted by MAxime on October 13, 2009, at 22:12:56
Seroquel worked for me. Also ativan. Parnate can cause insomnia but there are things you can take besides trazadone.
> Seriously? Damn. I need sleep. Last night I didn't sleep AT ALL. And tonight it doesn't feel like I am going to sleep either. There must be somehing that I can take?
Posted by MAxime on October 14, 2009, at 14:14:04
In reply to Re: Trazadone and Parnate, posted by g_g_g_unit on October 13, 2009, at 22:21:15
At this point I don't think it's the Parnate that is causing the insomnia. I'm a chronic insomnia sufferer. I just want to see if I can try something that goes safely with Parnate. Maybe I will try the Trazadone and see what happens. I don't want to start taking benzos because they are addictive and they cause depression in me.
Posted by MAxime on October 14, 2009, at 14:16:26
In reply to Re: Trazadone and Parnate » Maxime, posted by Sunbath on October 14, 2009, at 6:43:04
Thanks Sunbath. That is what I needed to hear. There are so many drugs that are contraindicated with Parnate, but you can still take them without any ill effects. I am not one for following the rules unless of course I know that I am going to have a very reaction.
I have a prescription for Trazadone that I think I will refill. Not much helps me sleep, but Trazadone will help for a while until it poops out.
Thanks again!
Posted by MAxime on October 14, 2009, at 14:18:05
In reply to Re: Trazadone and Parnate, posted by emmanuel98 on October 14, 2009, at 11:54:35
Thanks Emmanuel. There are not many meds out there that help me with sleep. Trazadone is one that actually works so that's why I thought I would ask. I've always suffered from insomnia, even without the Parnate.
Posted by Sunbath on October 14, 2009, at 19:28:45
In reply to Re: Trazadone and Parnate » Sunbath, posted by MAxime on October 14, 2009, at 14:16:26
Hey Maxime, but you are asking your doc aren't u?
GOOD LUCK!!!
Posted by MAxime on October 14, 2009, at 21:50:03
In reply to Re: Trazadone and Parnate » MAxime, posted by Sunbath on October 14, 2009, at 19:28:45
Nah, I'm not going to bother asking my doc. He isn't well versed in contraindicated meds. He is 87 years old and sometimes out of the loop.
Posted by Sunbath on October 15, 2009, at 6:26:22
In reply to Re: Trazadone and Parnate » Sunbath, posted by MAxime on October 14, 2009, at 21:50:03
Wow THAT's old!!! He must be a great doc!
But hey, only because I, who isn't at all compassing every aspect of these complex interactions, THINK it might be safe (and is for ME) doesn't at any means mean it really is or it is for you! Of course you know that :D But please ask him.. do you think he will say no?
I really don't want you to be in any danger!Please be cautious!! I hope you are getting better soon! Good luck :)
Posted by Maxime on October 15, 2009, at 13:03:07
In reply to Re: Trazadone and Parnate » MAxime, posted by Sunbath on October 15, 2009, at 6:26:22
Hey, I have emailed my pdoc to ask him about the Trazodone. I don't want you to feel responsible for my taking it. :-)
Posted by Maxime on October 15, 2009, at 17:06:51
In reply to Re: Trazadone and Parnate » Sunbath, posted by Maxime on October 15, 2009, at 13:03:07
I got the go ahead to take the Trazodone but he said to start with a small dose. So that's good news. :-)
Posted by Phillipa on October 15, 2009, at 20:24:14
In reply to Re: Trazadone and Parnate, posted by Maxime on October 15, 2009, at 17:06:51
Yes it is and you sound more positive Phillipa
Posted by Sunbath on October 16, 2009, at 2:34:03
In reply to Re: Trazadone and Parnate, posted by Maxime on October 15, 2009, at 17:06:51
Hey Maxime!!
Cool that you asked and thnx :)
GREAT that he gave you the go ahead!
Please tell us if it's working for your sleep and how much you're taking.. you don't have the extended release type trazodone over there have you?
Good luck Maxime!!
Posted by Maxime on October 16, 2009, at 10:28:25
In reply to Re: Trazadone and Parnate » Maxime, posted by Sunbath on October 16, 2009, at 2:34:03
No, we don't have the extended release Trazodone here.
I didn't sleep at all last night. :-( I was awake the WHOLE night.
I had planned on picking up the Trazodone today but my prescription is at a pharmacy that is about an hour away by bus. I just don't have the energy today to go and get it. I will go tomorrow.
Posted by Sunbath on October 16, 2009, at 10:30:06
In reply to Re: Trazadone and Parnate » Sunbath, posted by Maxime on October 16, 2009, at 10:28:25
Oh sh*t, that sounds horrible!!
You don't have someone to pick it up for you?
Do you have any benzos for today?
Posted by Maxime on October 16, 2009, at 11:27:49
In reply to Re: Trazadone and Parnate » Maxime, posted by Sunbath on October 16, 2009, at 10:30:06
No, there is no one who could pick it up for me. I don't have any benzos. I am hoping that I will sleep tonight from sheer exhaustion. I feel awful right now. :-(
Posted by Sunbath on October 17, 2009, at 5:23:51
In reply to Re: Trazadone and Parnate » Sunbath, posted by Maxime on October 16, 2009, at 11:27:49
That's terrible! Sorry that you have to go through that! Having no sleep is one of the worst things ever in my opinion.
How did you sleep that night?Are you able to pick up the trazodone today?
Posted by Maxime on October 17, 2009, at 11:02:37
In reply to Re: Trazadone and Parnate » Maxime, posted by Sunbath on October 17, 2009, at 5:23:51
I slept a bit last night, but not much. I am now off to the pharmacy to get the Trazodone. How many mg do you take? I need 200 mg to help me sleep. I hope that's not too much with the Parnate.
I don't understand how the Parnate can make me so tired all day and unable to sleep at night. ???
Posted by Sunbath on October 17, 2009, at 11:42:49
In reply to Re: Trazadone and Parnate » Sunbath, posted by Maxime on October 17, 2009, at 11:02:37
Hey Maxime, great you are getting it finally.
I take 175-200mg/night, but that is the extended release version so it's of course less than an equivalent of an immediate release one.I'm no expert but I think you shouldn't take 200mg the very first night already, especially not when on Parnate?!
Also I don't know if you also experienced this, but some kind of a tolerance to trazodone's sedative effects builds up the first 1-2weeks when I begin taking it (again). During that time I have to gradually increase my dose until I reach a certain level where tolerance doesn't develop any further... I don't know if it's the same for you though..
Maybe to begin with 75 the first night and if you don't feel ready for sleep after 30min-1hr then take another 50-75mg would be safer?What do you think?I also think it's very strange that we get tired during afternoon but are full of energy at night..
In current psychiatry vol 2002 they say:"An altered diurnal sleep cycle is another
MAOI-related side effect. Some patients get
extremely drowsy in the late afternoon but then
may have insomnia at night.26 Attempts to alter
this odd cycle by changing the timing of adminis-
tration have generally not helped. We add a stim-
ulantpemoline (18.75 to 35.5 mg), d-ampheta-
mine (2.5 to 5 mg), methylphenidate (5 to 10 mg), or
modafinil (50 to 100 mg)either in the morning or during
afternoon sleepiness, with good effect and no hypertensive
crises. We supervise the effect on blood pressure of the first
few doses. Another helpful alternative has been to administer
trazodone at night to initiate sleep."In another article I found they said that this effect wasn't completely understood.. maybe it's a mystery :D
Good luck Maxime, have a nice sleep tonight!!!
Posted by delna on October 18, 2009, at 4:04:55
In reply to Re: Trazadone and Parnate » Sunbath, posted by MAxime on October 14, 2009, at 21:50:03
Hi,
How are you doing on the Parnate? Have the suicidal thoughts gone or even improved? What dose are you up to and hows the sleep?
Hope you are better
Love
D
Posted by delna on October 18, 2009, at 8:39:46
In reply to Parnate- how are you going » MAxime, posted by delna on October 18, 2009, at 4:04:55
Posted by Maxime on October 18, 2009, at 11:36:40
In reply to Parnate- how are you going » MAxime, posted by delna on October 18, 2009, at 4:04:55
Thanks for asking. I am up to 30 mg of Parnate. I feel like sh*t. I am so tired during the day and not sleeping at night. I tried 200 mg of trazodone last night but it didn't work. I am thinking of suicide all the time and have come close to acting on my thoughts.
I'm not giving up on the Parnate yet because it's too early. I need to get the dosage up.
If I could get a decent night's sleep I think it would make a big difference to my mood.
Posted by delna on October 18, 2009, at 12:03:29
In reply to Re: Parnate- how are you going » delna, posted by Maxime on October 18, 2009, at 11:36:40
> Thanks for asking. I am up to 30 mg of Parnate. I feel like sh*t. I am so tired during the day and not sleeping at night. I tried 200 mg of trazodone last night but it didn't work. I am thinking of suicide all the time and have come close to acting on my thoughts.
>
> I'm not giving up on the Parnate yet because it's too early. I need to get the dosage up.
>
> If I could get a decent night's sleep I think it would make a big difference to my mood.Maxime, how long has it been on 30mg? I'm sad that you are still suicidal. I gave up on Parnate myself and missed 2 days but restarted yesterday at 20mg. Know that you are not alone I am also struggling with suicidal feelings and crippling side effects.
Do you feel you will get a better response at 40mg. If so how much longer do you have to wait?I'm sure a good nights sleep will help. Problem is how to get one. You seem so resistant. I don't know if low dose seroquel has been suggested or if you have tried it but I believe its good.
I hope you find a good sleep aid- sorry I can't help on that one....insomnia has never been a problem for me.Well take care and keep in touch.
Lots of love
D
Posted by Meltingpot on October 18, 2009, at 12:15:03
In reply to Re: Parnate- how are you going » Maxime, posted by delna on October 18, 2009, at 12:03:29
Maxime,
Can't you try taking 10mg of Zyprexa now and again just to get some sleep. I'm not sure if would work for you but Zyprexa has always zonked me out.
It would be definately worth a try.
Denise
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