![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by europerep on January 4, 2011, at 17:51:28
hello there..
I'm now in my fifth week with Parnate (tranylcypromine), started 50mg/d yesterday, and besides the fact that I don't feel any better whatsoever, I actually even feel like it's getting worse... the past weeks after going off of venlafaxine are all a little hazy because I have been doing nothing at all, stopped goin to university and so on.. so, it's a little difficult to compare, but I think I feel worse now than between them two meds.. I want to go to 60mg/d to see what happens, and possibly even to 70-80mg, but who knows what that'll do to me then?Parnate was basically my only hope left... if it doesn't work, then.. I'd have to have ECT or whatever, but I'm not going to do that.. I am only 24!! maybe I'm not meant to live much longer than this, not everyone has the luck to meet someone, have a family, and do all the other things in life that I have always dreamed of... :'-(
Posted by Maxime on January 4, 2011, at 23:26:30
In reply to I think Parnate is making me actually worse.., posted by europerep on January 4, 2011, at 17:51:28
Yes, you are meant to live longer than 24 years. I can promise you that.
Maybe you should stay at 50 mg until you start to feel a little better. If you ramp up the Parnate too fast, you are not going to feel very good at all.
What other meds do you take with the Parnate?
Posted by europerep on January 5, 2011, at 6:17:59
In reply to Re: I think Parnate is making me actually worse.. » europerep, posted by Maxime on January 4, 2011, at 23:26:30
Hmm, I thought going up by 10mg per week was even relatively slow, or at least not overly fast. Can it really make me feel worse by going up too quickly? I know escalating doses quickly isn't good, but I thought that was due to hypertensive issues and stuff like that.
I'm taking nothing else besides 10mg of zolpidem nightly. I have been wondering whether a downer lik zolpidem could actually "kill off" the mood-brightening effects, but it says that tranylcypromine can be combined with benzos (and em98, who is getting a good response from it as it seems, does take it with lorazepam for example). So I suppose the same is true for "z-drugs".
I'm scared to keep taking it and somehow doing even more "damage" to my brain than it already has...
Posted by maxime on January 5, 2011, at 15:39:41
In reply to Re: I think Parnate is making me actually worse.. » Maxime, posted by europerep on January 5, 2011, at 6:17:59
10 mg per week is slow, but maybe that is how your body wants you to do it. If you are experience adverse effects, it makes sense to stay at the dosage you are on until the effects go away.
Have you talked to your pdoc about it?
Posted by europerep on January 5, 2011, at 17:07:04
In reply to Re: I think Parnate is making me actually worse.. » europerep, posted by maxime on January 5, 2011, at 15:39:41
Argh, damn, you got me :).. I don't really have a pdoc at the moment, to be honest. I prescribed tranylcypromine to myself, over the internet, after doctors here either didn't know what MAOIs are or categorically refused to prescribe them ("we've stopped using them 20 years ago"..). I really tried to do it the legitimate way, but it just didn't work. So I gathered really all the information available on the drug, including spontaneous hypertensive crises, about fifteen different food lists, etc., and I am confident I really have all the information about the drug I could possibly get. I am basically raising the dosage so slowly *because* I don't want to have any preventable trouble from being too impatient. Of course I know doctors here (plenty of 'em by now), so if I ever needed advice I could get it, but if I went there now, they would tell me to get off of it anyway...
I am really wondering what to do now though. Today I spent almost two hours lying on the bathroom floor, wondering whether to take a shower or not. It's not so much "adverse effects", but rather the original condition for which it was prescribed (*cough*) being worsened by it. This is either due to tranylcypromine, or despite it, but to me it really seems more like "due to". I agree, I won't go up any further now, but I wonder whether this is actually sustainable. And this worsening is not something I noticed suddenly, I had noticed it for a while, I just thought it was more due to the disappointment that it hadn't kicked in yet... *sigh* beginning-of-the-21st-century medicine sucks!
(btw, you mentioned once that your pdoc will come here and check your posts every now and then.. I really hope he won't read this, seeing a patient prescribing tranylcypromine to himself must be pretty weird for a doctor :) )
Posted by Sailboat77 on January 5, 2011, at 18:07:51
In reply to Re: I think Parnate is making me actually worse.. » maxime, posted by europerep on January 5, 2011, at 17:07:04
I know how you feel being in your 20's and thinking nothing will work for your life. After ECT and Nardil, I thought I had no more options left. I switched to Parnate and for the first week I felt more depression. But after 3 weeks, I'm starting to get "some" improvement (I still struggle with lack of pleasure in fun activities).
The thing is, I felt the same despair. The Parnate hasn't been perfect so I still have the challenging option of adding a small amount of Adderall/Vyvanse for additional help, but if this doesn't work, I'm back to square 1 without knowing where to go next.
There are always options, even when you don't feel like there are many. I know how hard it is took look ahead at a long life dealing with hurtful depression, but there is hope.
Posted by g_g_g_unit on January 5, 2011, at 19:06:55
In reply to Re: I think Parnate is making me actually worse.., posted by Sailboat77 on January 5, 2011, at 18:07:51
I hate to say it, but Parnate made me feel profoundly more 'flat', amotivated, fatigued, etc. I gave it over 8 weeks, but the symptoms never seemed to remit. There are others on the board who responded poorly to the drug.
Like you, I'm still relatively young and don't have too many options left, so rather than writing Parnate off, I've wondered whether things would have improved with time.
Posted by Maxime on January 5, 2011, at 22:39:43
In reply to Re: I think Parnate is making me actually worse.. » maxime, posted by europerep on January 5, 2011, at 17:07:04
>
> (btw, you mentioned once that your pdoc will come here and check your posts every now and then.. I really hope he won't read this, seeing a patient prescribing tranylcypromine to himself must be pretty weird for a doctor :) )Don't worry he has seen everything. Nothing shocks him anymore. ;)
Posted by Maxime on January 5, 2011, at 22:46:00
In reply to I think Parnate is making me actually worse.., posted by europerep on January 4, 2011, at 17:51:28
I think I may have already asked you this in another thread. But where does your Parnate come from? Does it look the way it is supposed to? (Each round, rose-red, film-coated tablet is debossed with the product name PARNATE)
Posted by europerep on January 6, 2011, at 6:10:19
In reply to Re: I think Parnate is making me actually worse.. » europerep, posted by Maxime on January 5, 2011, at 22:46:00
> I think I may have already asked you this in another thread. But where does your Parnate come from? Does it look the way it is supposed to? (Each round, rose-red, film-coated tablet is debossed with the product name PARNATE)
I think I am not allowed to reveal where exactly I get it from :(.. it's not the actual parnate though, I use that word because everyone here is more familiar with it, I receive the German version, which is called Jatrosom (and I happen to be German, so it's appropriate I guess haha). Of course I have wondered about it being the real deal, but here's why I think it isn't fake:
- tranylcypromine is off-patent and quite cheap, plus it sells poorly, so anyone making the effort to fake a drug (including the box, leaflet, etc.), would choose something else to make profits
- the pills look exactly like they are described on their official website, as does the box, the notice and the the "help for severe depression leaflet"
- the side effects I get are exactly the ones one would suppose to have with an amphetamine analogue, namely sleep issues, slight appetite suppression and slight stimulant effects from T+30min. until about T+90min. (where T is the point where I take my first dose).. this last effect is btw rarely described on this board, but it's featured in the FAQ of my version of the drug.. this makes me wonder whether the actual Parnate is slightly more slow-releasing or something...
I have decided to go off of tranylcypromine though. If I keep taking it, I can't know for sure whether it's it or my depression that's making me the way I feel, whereas if I go off and things don't change, I know it wasn't the drug. If it were just not working yet, I would really want to give it the whole 6 weeks at the target dose, but this right here is just too bad. If I won't improve even off parnate, I can still restart it together with a TCA maybe (though I would do that only with a clinician)...
Posted by europerep on January 6, 2011, at 6:19:55
In reply to Re: I think Parnate is making me actually worse.., posted by Sailboat77 on January 5, 2011, at 18:07:51
Yeah, I too have thought about augmenting, but it would seem pointless to augment a drug that doesn't work at all, or that makes things even worse, I guess.. maybe it's my only option though..
I think when parnate is somewhat effective, augmenting it or raising the dosage above the usual dose range can actually be a good thing, at least according to what I've read...
how was ECT for you, esp. in terms of side-effects?
Posted by Maxime on January 6, 2011, at 20:44:46
In reply to Re: I think Parnate is making me actually worse.. » Maxime, posted by europerep on January 6, 2011, at 6:10:19
Posted by Sailboat77 on January 6, 2011, at 21:34:04
In reply to Re: I think Parnate is making me actually worse.. » Maxime, posted by europerep on January 6, 2011, at 6:10:19
ECT actually works for some people... it just didn't for me. I wouldn't say I felt worse after getting the full amount of treatments (I can't remember the number), but I would say that I felt kind of weird and out of it.
There were no noticeable side effects besides the treatment itself being physically exhausting. I wish you luck though if you choose to try it.
Posted by europerep on January 7, 2011, at 5:56:02
In reply to Re: I think Parnate is making me actually worse.. (nm), posted by Maxime on January 6, 2011, at 20:44:46
Hm, did you unintentionally tick the (nm) box instead of "add name of previous poster"? That would suck, I hope it didn't take you a long time to write your reply... This forum script is so archaic ;)
Posted by europerep on January 7, 2011, at 6:13:52
In reply to Re: I think Parnate is making me actually worse.., posted by Sailboat77 on January 6, 2011, at 21:34:04
Well, it's true, *some* people do profit from it, and I can't know if I would do so or not without trying but... then what? I would need ECT for the rest of my life, and I am sure it would lose its efficacy at some point. Also, I read of someone about my age who had ECT without success, but who basically forgot all his past years of university study, and had to drop out of his courses because he just couldn't continue it.. even if chances of that are low, I won't take that risk.
To be honest, in the long run (!), suicide has become a viable option for me. I have basically been ill since age 10 - first anxiety, which made me miss out on almost everything because I didn't dare leaving the house, then from 16 on depression, which made me miss out on almost everything because I just cannot enjoy myself or anything I do. the others at my age, and even those who are much younger than me, are *so* far ahead of me in terms of everything that makes up actual life, I will never be able to make up for all these years... :(..
for now, I will try something different though, and if that doesn't work, I will reevaluate my perspectives. on christmas, for the first time since a long while ago, I smoked some weed again (I know it was a bad on an MAOI, but hey I survived... unfortunately) and for the first time in so long, I actually felt good about myself, I was eager to interact socially etc.. the day after, I sent mails out to friends who I hadn't contacted for soo long (their last contact to me was when they sent me a happy birthday message at the beginning of 2010, and I didn't even bother to reply), and so on. I found a university psychiatrist who gave me an address of a doctor who *may* be willing to prescribe me dronabinol (semi-synthetic THC) against my depression. There is quite some research going on, looking into how to raise endocannabinoid levels which are significantly lowered in many people with depression.. until they find some agents who do that though, the only way would be to bring in exogenous cannabinoids.. it may not be the best way to treat depression, but if it *is* one, I'm willing to take it. I would rather take a controversial drug than continue living like this, which would mean taking my life at some point sooner or later anyways...
sorry for the ramble, had to say that.. I'll see that doc one and a half weeks from now, obviously I'll still have to get rid of tranylcypromine, which will take a little longer, but then I'll know whether she'll eventually prescribe it to me or not...
Posted by Maxime on January 7, 2011, at 19:17:52
In reply to Re: I think Parnate is making me actually worse.. » Maxime, posted by europerep on January 7, 2011, at 5:56:02
> Hm, did you unintentionally tick the (nm) box instead of "add name of previous poster"? That would suck, I hope it didn't take you a long time to write your reply... This forum script is so archaic ;)
Yes I did. :( Darn!
I was going to you a few things, but I can't remember them all. Oh, do you know where your parnate is coming from? Is it coming from India?
I once ordered Nortriptaline over the net and it came from India. It didn't even look like Nortriptaline. I was too scared to take it. I can't tell you why I ordered it. But around the same time I got a precription for the med and I bought it here.Have you thought about trying Nardil? Maybe it would work better for you. I find usually people are "parnate people" or "Nardil people". It's worth a shot!
Posted by Maxime on January 7, 2011, at 19:22:57
In reply to Re: I think Parnate is making me actually worse.. » Sailboat77, posted by europerep on January 7, 2011, at 6:13:52
...
>
> sorry for the ramble, had to say that.. I'll see that doc one and a half weeks from now, obviously I'll still have to get rid of tranylcypromine, which will take a little longer, but then I'll know whether she'll eventually prescribe it to me or not...I pray that she prescribes it for you. Or Nardil.
Please don't think of suicide right now. You haven't explored all your options. I would be so sad if one day you disappeared and stopped posting.
Hugs,
Maxime
Posted by europerep on January 8, 2011, at 6:44:17
In reply to Re: I think Parnate is making me actually worse.. » europerep, posted by Maxime on January 7, 2011, at 19:22:57
> >
> > sorry for the ramble, had to say that.. I'll see that doc one and a half weeks from now, obviously I'll still have to get rid of tranylcypromine, which will take a little longer, but then I'll know whether she'll eventually prescribe it to me or not...
>
> I pray that she prescribes it for you. Or Nardil.
>
> Please don't think of suicide right now. You haven't explored all your options. I would be so sad if one day you disappeared and stopped posting.
>
> Hugs,
> MaximeThanks, that's very nice of you!
As for your first question, my "Parnate" is actually coming from Germany, and I received it within days of ordering, so I'm quite sure they didn't backorder it from somewhere else like India. I can understand your concerns about Indian products, although they do make a lot of quality stuff over there too (I think 50% of the medication the UN dispenses comes from India).. I too was surprised though when Christ_Emp mentioned that his doc was allright with him importing abilify from there.. that's still a patented product after all!
I have also thought about Nardil of course.. I'm thinking, if I don't have anxiety, and an MAOI actually makes me feel worse, there's no real point in trying it.. but I will keep it in mind of course.
You know, I just wonder what would be the point if I kept on living like this for another set of years, and then I come out of depression at 30 or whatever.. there's no way I am currently able to finish my studies (or work), so I would have to start all over by then. there's no way I would not be totally, 100% alone by that point, and seeing my personal history with regards to these issues, I surely won't then be able find anyone. In short, my life would simply suck. I *am* giving myself some more time, so don't worry, but like you I have set aside some meds I would need "au cas oł" (I can't let them go unused after all haha - sorry that was a bad joke)... I don't want to spend life as a stupid idiot who hasn't been able to reach a single one of all the goals he has had in life, most of them being ones that others can have *so* easily... And the point is not that I cannot stand myself - well, not like this, but I used to like myself, as did others, it's just that now I am not able to have even the slightest meaningful social interaction, and this is soo frustrating. If this is how my life is meant to be, then I just don't want it. But, as I said, don't worry, I have given myself some time (and a list of meds or things I want to try), and if none of them does anything for me, I'll see what I'll do by then..
Hugs back, if I may :)...
Posted by g_g_g_unit on January 9, 2011, at 3:58:47
In reply to Re: I think Parnate is making me actually worse.. » Sailboat77, posted by europerep on January 7, 2011, at 6:13:52
>
> To be honest, in the long run (!), suicide has >become a viable option for me. I have basically >been ill since age 10 - first anxiety, which made >me miss out on almost everything because I didn't >dare leaving the house, then from 16 on >depression, which made me miss out on almost >everything because I just cannot enjoy myself or >anything I do. the others at my age, and even >those who are much younger than me, are *so* far >ahead of me in terms of everything that makes up >actual life, I will never be able to make up for >all these years... :(..
>As someone who's roughly your age (and who's been unwell since 17 or so), this is something I invariably try not to think about, but it's true . . . at this point, even if I do get better in my 30s, the amount of time and life experience that's been lost to this disease is enough to turn my stomach. It almost feels like the prospect of getting well is as fraught with conflict as remaining depressed.
Posted by europerep on January 9, 2011, at 13:35:48
In reply to Re: I think Parnate is making me actually worse.. » europerep, posted by g_g_g_unit on January 9, 2011, at 3:58:47
>
> As someone who's roughly your age (and who's been unwell since 17 or so), this is something I invariably try not to think about, but it's true . . . at this point, even if I do get better in my 30s, the amount of time and life experience that's been lost to this disease is enough to turn my stomach. It almost feels like the prospect of getting well is as fraught with conflict as remaining depressed.
>Hm, yeah, that's really the thing.. of course I will (or I would) have a somewhat different view on that once I get out of depression, but still... Depression, and particularly long-lasting depression, with an early onset is really so much different from "regular" depression.. and I admit that sometimes I do feel like it's worse, even though that may be unjustified. It's not by chance that so many people look back on these years as the best part of their life.. :(
Posted by bleauberry on January 10, 2011, at 13:50:22
In reply to I think Parnate is making me actually worse.., posted by europerep on January 4, 2011, at 17:51:28
Meds and plants that are commonly assumed to potentially improve mood can also do the opposite. So what you are feeling deserves notice. You could indeed be correct....you feel worse because it's making you worse.
But then, the murky period between meds can go on for quite a while. You may be temporarily stuck in a slow healing phase between effexor and parnate.
Parante is by no means a last resort. Have you ever done any of these.....zoloft+nortriptyline; prozac+nortriptyline; prozac+ritalin; anything+zyprexa.
Have you stopped eating all wheat/barley/barley malt products for a week to see what happens? Dairy too? Just to see?
Have tried 3 days of 12.5mg DMSA to see what happens?
Have you tried 2 weeks of Tetracycline or Doxycycline to see what happens? Notice I did not mention any tests to identify any possible infections because most of them are woefully inaccurate or do not exist. Long story. A true diagnosis is done by the reaction to a blind trial.
Tried a blood type diet? Some people feel a ton better on carb diets, others on protein diets, a blood type test can identify likelihoods as well as common foods that are offensive for certain blood types.
Vitamins. Is your B12 methylcobalamin? If not, then it needs to be tried. Same with B6....needs to be P5P just to see. Same with folate...needs to be methyltetrahydrofolate. These are all hard to find but Thorne Research has them all.
SAMe? St Johns Wort? Siberian ginseng? Rhodiola Rosea? How about the story of the famous psychiatrist's wife who didn't get better on any meds but recovered completely on Rhodiola and it is now commonly prescribed by that psychiatrist? Ya know...there's stuff.
The universe of tools the psychiatric world gives us is pitifully small and narrowly targeted. There are multiple causes of chronic stubborn depression, and most of them do not originate within the brain. The brain is only the poor guy that takes the hit from the crap going on elsewhere. If we picture depression as a pie, the psychiatric meds only represent a piece of that pie, maybe about 1/4 of the pie at most. The rest of the pie is totally ignored as if it doesn't exist.
A one day trial of vicadin? This would help identify if it is an endorphin depression, which would pave the way for things like DLPA or LDN or tramadol.
Are your food choices mostly veggies and fruits? Very little sugars, modest or no caffeine? What if we put junk contaminated gasoline not appropriate for our car in our car. It will still burn and the car will still run, but it will run depressed. What we eat makes a difference.
Food for thought. Somewhere in this post is your answer.
All of the above cover most of the common causes I am aware of....heavy metals, unsuspected chronic infections and their devastating complications in the brain, inflammation of the brain, food sensitivities or allergies (usually the ones you crave the most), genetic flaws in making neurotransmitters, hormones screwed up, biotoxins from microbials, and improper diagnosis of exactly what kind of depression we're dealing with.
As an ECT survivor, I would not even put that anywhere on the list. All of the above take much higher priority and have something ECT cannot offer....long lasting results. ECT in my opinion is only for emergencies, the very sick who cannot even live outside a hospital. It takes a while to kick in if it is going to kick in, doesn't kick in as good as literature suggests, and rarely lasts very long when it does. There are very few stories where someone can say, "ECT was the answer I was looking for". It can be, and was for me, a sort of stepping stone to get from one chapter to the next, but the next chapter isn't much better...it's just not stuck in the old one anymore.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.