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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by cubbybear on February 27, 2003, at 10:54:13
I previously had 18 yrs. successful experience with Parnate and am slated to start it again (after failed attempts with 3 of the other "new and improved" ADs). With Parnate, I used to st art up this way: 20 mg. for the first two days, 30 mg. for the next 3 days, then 40 mg. maintenance dose. This was my tried-and true formula for what was called "moderate" depression.
Now things are different. My depression this time around is 1000 times worse than it ever was.
I realize I should be asking my pdoc these questions, but since I relocated, he writes and sends my scripts via mail and he is virtually impossible to contact via phone. So if I can't get hold of him soon enough, I'll consider the responses I get from all of you.
For really severe depression, do you think I should still go about it the same way I always did? Or do you think I should go to a higher dose? Or better yet, does anyone have a copy of the PDR from which they can quote me the official dosing schedule?
It's the doctors who should be answering these questionsfor us patients but it's probably easier getting hold of Saddam Hussein on the phone than your own doctor.
Any help would be appreciated.
Posted by Jonathan on February 27, 2003, at 16:23:28
In reply to Parnate for Severe Depression--Need Dosage Info, posted by cubbybear on February 27, 2003, at 10:54:13
The British National Formulary (BNF) is the UK equivalent of your PDR. You can access it online at http://bnf.vhn.net/ ; you have to register and choose a username and password, but it's free, and the same login gives you access to the more detailed Electronic Medicines Compendium (EMC) at http://emc.vhn.net/ . Unfortunately, the latter doesn't include Parnate, the BNF entry for which is at:
http://www.bnf.vhn.net/bnf/documents/bnf.863.html#BNFID_3346
"Dose: initially 10 mg twice daily not later than 3 p.m., increasing the second daily dose to 20 mg after 1 week if necessary; doses above 30 mg daily under close supervision only; usual maintenance dose 10 mg daily; CHILD not recommended."
This is from the US online source http://www.rxlist.com/ :
http://www.rxlist.com/cgi/generic2/tranylcypromine_ids.htm
"The usual effective dosage is 30 mg per day, usually given in divided doses. If there are no signs of improvement after a reasonable period (up to 2 weeks), then the dosage may be increased in 10 mg per day increments at intervals of 1 to 3 weeks; the dosage range may be extended to a maximum of 60 mg per day from the usual 30 mg per day."
Neither gives any guidance on varying the schedule for severe depression in patients like you who have previously tolerated a high dose; and I wonder how many of those for whom Parnate has worked would have abandoned it as ineffective if their doctor had been guided by the BNF?
I'm sorry I cannot be more helpful, Cubbybear.
I suggest that you try posting your question to this new egroup - several of its 54 members are taking Parnate:
Posted by michael on February 28, 2003, at 3:05:58
In reply to Parnate for Severe Depression--Need Dosage Info, posted by cubbybear on February 27, 2003, at 10:54:13
> I previously had 18 yrs. successful experience with Parnate and am slated to start it again (after failed attempts with 3 of the other "new and improved" ADs). With Parnate, I used to st art up this way: 20 mg. for the first two days, 30 mg. for the next 3 days, then 40 mg. maintenance dose. This was my tried-and true formula for what was called "moderate" depression.
> Now things are different. My depression this time around is 1000 times worse than it ever was.
> I realize I should be asking my pdoc these questions, but since I relocated, he writes and sends my scripts via mail and he is virtually impossible to contact via phone. So if I can't get hold of him soon enough, I'll consider the responses I get from all of you.
> For really severe depression, do you think I should still go about it the same way I always did? Or do you think I should go to a higher dose? Or better yet, does anyone have a copy of the PDR from which they can quote me the official dosing schedule?
> It's the doctors who should be answering these questionsfor us patients but it's probably easier getting hold of Saddam Hussein on the phone than your own doctor.
> Any help would be appreciated.check out dr. ivan goldberg's site (depressioncentral.com - I think) & check pb's tips section - search for parnate.
I'm not certain, but I think both have info on high dose (much higher than 30 or 40 mg) parnate.
Its not "typical" but its not as outlandish or unheard of as the pdr info would lead you to believe. Good luck.
michael
Posted by cybercafe on February 28, 2003, at 18:00:36
In reply to Re: Parnate for Severe Depression--Need Dosage Info » cubbybear, posted by michael on February 28, 2003, at 3:05:58
> > I previously had 18 yrs. successful experience with Parnate and am slated to start it again (after failed attempts with 3 of the other "new and improved" ADs). With Parnate, I used to st art up this way: 20 mg. for the first two days, 30 mg. for the next 3 days, then 40 mg. maintenance dose. This was my tried-and true formula for what was called "moderate" depression.
> > Now things are different. My depression this time around is 1000 times worse than it ever was.
> > I realize I should be asking my pdoc these questions, but since I relocated, he writes and sends my scripts via mail and he is virtually impossible to contact via phone. So if I can't get hold of him soon enough, I'll consider the responses I get from all of you.
> > For really severe depression, do you think I should still go about it the same way I always did? Or do you think I should go to a higher dose? Or better yet, does anyone have a copy of the PDR from which they can quote me the official dosing schedule?
> > It's the doctors who should be answering these questionsfor us patients but it's probably easier getting hold of Saddam Hussein on the phone than your own doctor.
> > Any help would be appreciated.
>
> check out dr. ivan goldberg's site (depressioncentral.com - I think) & check pb's tips section - search for parnate.
>
> I'm not certain, but I think both have info on high dose (much higher than 30 or 40 mg) parnate.
>
> Its not "typical" but its not as outlandish or unheard of as the pdr info would lead you to believe. Good luck.
>
> michaeli found it very effective but took a long time to kick in
Posted by cubbybear on March 1, 2003, at 3:15:06
In reply to Re: Parnate for Severe Depression--Need Dosage Info, posted by cybercafe on February 28, 2003, at 18:00:36
> >
> i found it very effective but took a long time to kick inWhat do you mean by a long time? About how many weeks/ And what dosage did you take?
cubbybear
Posted by cybercafe on March 1, 2003, at 13:33:50
In reply to Re: Parnate for Severe Depression--Need Dosage Info » cybercafe, posted by cubbybear on March 1, 2003, at 3:15:06
> > >
> > i found it very effective but took a long time to kick in
>
> What do you mean by a long time? About how many weeks/ And what dosage did you take?
> cubbybear
>
>first i get the stimulant effects... feel real good for about a month
then i get used to them, feel worse for the second month
then i seem to really get adjusted to the MAO inhibition and see improvementparnate was a great med for me
i only took 30 mg too... (lowest dose) ... i am used to taking high dosages of meds
i also read people who saw a big anxiolytic response around the third month
This is the end of the thread.
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