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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by MrChips on April 21, 2015, at 21:57:16
Hi. I wonder if anyone experienced with Parnate could offer some insight.
I started taking Parnate (currently 50mg split into two doses) a couple of months ago and it's been going well, except for the following problem (which also occurred at all previous dosages).
While the first daily dose (30mg) causes the more typical hypotension (maybe not strictly, but it lowers my BP significantly), the second dose (20mg) has the opposite effect: BP consistently rises an hour after taking it to about 140/90 for 2-3 hours (say from 115/75, which it is usually close to).I know it's not really a dangerous BP but when I start getting anxious about it, it starts creeping up even more (170/100), at which point I start chewing some extra Propranolol (which I also take daily at the same time as both doses of Parnate), holding it in my mouth, which brings the BP down.
The rise in BP is proportional to the time between the first and second dose, so I end up taking it quite late in the day to minimize this effect, but then the insomnia is worse. Even nine hours apart still raises BP. If I take it as recommended by my psychiatrist (second dose 3-4 hours after first) the hypertension lasts much longer and is more severe (precisely when I would otherwise have low BP from the first dose!).
Anyway, it really bugs me that the two doses should have opposite effects, as its half life is apparently short enough that there should be no additive effect and I'm careful with diet. It was the same when I was taking 10mg twice a day, so I don't think the total dose is the issue. I wonder if it has something to do with an interaction between its two enantiomers, but I can't make much sense of that.
I'm considering taking the full dose once a day in the morning but worried that it's too much to take at once, especially if/when it is increased (presumably it would lower my BP even more).
Posted by PeterMartin on April 22, 2015, at 0:27:37
In reply to Curious Parnate hypertension, posted by MrChips on April 21, 2015, at 21:57:16
I don't have a solution or explanation but I did want to say that I experienced a similar situation with Parnate where my bp would spike after even a 10mg dose. I ended up switching to Marplan. I know it's uncommon so just wanted to put a comment so you know it's not completely unheard of. I was also taking Lamictal and Lithum at the time (2010ish). Hopefully a different dosing schedule will work for you.
Posted by baseball55 on April 22, 2015, at 19:46:45
In reply to Curious Parnate hypertension, posted by MrChips on April 21, 2015, at 21:57:16
Why do you keep taking your BP, given that it doesn't rise to dangerous levels? What difference does it make?
Posted by MrChips on April 23, 2015, at 2:36:52
In reply to Re: Curious Parnate hypertension » MrChips, posted by baseball55 on April 22, 2015, at 19:46:45
> Why do you keep taking your BP, given that it doesn't rise to dangerous levels? What difference does it make?
I don't keep taking it, just when I can feel it's particularly high (slow pulse/tight chest), as it seems prudent to note if there are any changes (170/100 does seem a bit alarming though).
It's more the case that I'm just curious as to why the two doses have different effects and to see if others get this too.
Posted by ikasug on April 23, 2015, at 10:21:35
In reply to Re: Curious Parnate hypertension, posted by MrChips on April 23, 2015, at 2:36:52
You said you chewed propanolol-- do you have a history of high blood pressure? I would imagine a preexisting blood pressure problem is a contraindication for Parnate. Parnate typically reduces blood pressure so I wouldn't mix it with blood pressure medication. It's also possible you'd see your blood pressure level out as you get used to the dose you're at.
Posted by MrChips on April 23, 2015, at 16:28:09
In reply to Re: Curious Parnate hypertension, posted by ikasug on April 23, 2015, at 10:21:35
> You said you chewed propanolol-- do you have a history of high blood pressure? I would imagine a preexisting blood pressure problem is a contraindication for Parnate. Parnate typically reduces blood pressure so I wouldn't mix it with blood pressure medication. It's also possible you'd see your blood pressure level out as you get used to the dose you're at.
I take Propranolol for anxiety. I've had normal to low BP for years. I think MAOI's were used in the past to treat high blood pressure. Apart from the few hours of hypotension after the first dose of Parnate, BP is higher overall.
This is the end of the thread.
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