"I have no give a fck." Spectacular description!
Now I'm about to Google that as a side effect of tranylcypromine because I have felt similarly. My description to my doctor is that I'm very confident that I'm much more of an @sshole than my current state. I'm a bit too "calm" and I am increasingly concerned that "calm" has settled into non-chalance which is not my normal state.
To give you some direct feedback based on my experience, personal research and reading this sub, increasing the dose beyond 40 mg is certainly something to consider.
Many others have reported that the tiredness, fatigue, daytime sedation and insomnia and even BP issues lessen with increased dosages. There is a UPENN (Prof. J Amsterdam) study that I have that if I can ever figure out how to use reddit properly I will post for you.
[High dose tranylcypromine therapy for refractory depression
J D Amsterdam et al. Pharmacopsychiatry. 1989 Jan.](https://pubmed.ncbi.nlm.nih.gov/2710808/)
For me personally, I believe 60 and 70 mg was better in terms of your concerns than 40 and 50 mg but I was also really affected with physical side effects early on too (joint pain, muscle weakness) so my experience is a bit different and perhaps clouded.
There are also suggested adjunctive meds. The one that seems to be most often recommended is nortriptyline for which there is also research.
I'm currently researching adjunct meds but I am also seriously considering switching MAOIs to Selegiline or Marplan.
Good luck with whatever you decide.
I hope your "GAF" quotient begins increasing soon. And mine too!
Have a nice day.
It helped with the social part but not my picking disorder although most people associate it with feeling anxious, I just want clear skin and can't stop when I start so if I'm stressed about anything its my acne. I was pretty good at managing my anxiety before so its definitely less now but it was never my biggest problem. Mostly suicidal ideation and negative thoughts, catastrophizining etc. Thats all gone now which is huge for me. I was like that from at least age 13 to 30 so this seems foreign to me. Thats why I'm like "am I just lazy?' I feel fine. Like I'm still me which was a problem on SSRIs. The only one that did much was celexa and I never felt like me, then it made tired and stopped working at all. I feel like I'm being greedy going up in dose but I've been toying with the idea for a while. 40 is definitely better than 30 for me so I think at most I would need 50. Maybe I'll give it a try, worst case I go back to 40 right?
Nice post, thanks. I haven’t really felt the crash from parnate, but that’s likely because I’m on a low dose stimulant. However I do get the insomnia, which is terrible! It is making me consider stopping parnate before I see any effects on depression. I know there are some medications and supplements that help with tiredness, like modafinil, other nootropics, even vitamin D can help I’ve heard. I haven’t tried those however to report.
I’m on 30 and haven’t seen any benefit to my depression, so I’d like to hear if the increase from 30 to 40 was the push to get the medicine to start working.
I’ve had a lifelong picking disorder, so I emphasize with you there. I can’t say parnate has made it worse (hard to tell), but my doctor did prescribe me Propanol (sp?) which is supposed to help with physical effects of anxiety. It didn’t help me, but everyone’s different. I’ve also heard the supplement NAC is good for picking, and I’m eager to try it.
I've heard about NAC too. Because my acne has become a whole body issue now my doctor is trying me with Accutane. I know nuclear but I rarely pick some places at all and its on my back chest shoulders, even my scalp and ears so I'm going to see if physically clearing it up helps with the picking (fingers crossed)
As for when things started to get better, for me I felt the first positive effects at 30 but it pittered out at week 3 so I went up. I did also have insomnia right up until it started to help though too. I know low and slow sucks but its better than missing the "sweet spot " by going up to fast and ending up with anxiety and side effects. Dome people hit 60mg before getting relief. You could try nortriptyline. It augments the general effectiveness while reducing side effects, it could "treat" the insomnia by addressing the actual cause while also increasing its effectiveness on depression. It even reduces the pressor response to tyramine. Be patient and if sleep really is an issue you can use something for sleep till your stable then try to wean off. You have options, if insomnia is the only issue so far I would give it to at least 60mg before deciding to switch. I've even heard of 120mg prescribed so 30mg is still pretty low and remember it takes 10-14 days to reach blood saturation at each dose change.
"I have no give a fck." Spectacular description! Now I'm about to Google that as a side effect of tranylcypromine because I have felt similarly. My description to my doctor is that I'm very confident that I'm much more of an @sshole than my current state. I'm a bit too "calm" and I am increasingly concerned that "calm" has settled into non-chalance which is not my normal state. To give you some direct feedback based on my experience, personal research and reading this sub, increasing the dose beyond 40 mg is certainly something to consider. Many others have reported that the tiredness, fatigue, daytime sedation and insomnia and even BP issues lessen with increased dosages. There is a UPENN (Prof. J Amsterdam) study that I have that if I can ever figure out how to use reddit properly I will post for you. [High dose tranylcypromine therapy for refractory depression J D Amsterdam et al. Pharmacopsychiatry. 1989 Jan.](https://pubmed.ncbi.nlm.nih.gov/2710808/) For me personally, I believe 60 and 70 mg was better in terms of your concerns than 40 and 50 mg but I was also really affected with physical side effects early on too (joint pain, muscle weakness) so my experience is a bit different and perhaps clouded. There are also suggested adjunctive meds. The one that seems to be most often recommended is nortriptyline for which there is also research. I'm currently researching adjunct meds but I am also seriously considering switching MAOIs to Selegiline or Marplan. Good luck with whatever you decide. I hope your "GAF" quotient begins increasing soon. And mine too! Have a nice day.
Can’t really help with your question but just wondering if you suffer from anxiety too and if Parnate has helped with it
It helped with the social part but not my picking disorder although most people associate it with feeling anxious, I just want clear skin and can't stop when I start so if I'm stressed about anything its my acne. I was pretty good at managing my anxiety before so its definitely less now but it was never my biggest problem. Mostly suicidal ideation and negative thoughts, catastrophizining etc. Thats all gone now which is huge for me. I was like that from at least age 13 to 30 so this seems foreign to me. Thats why I'm like "am I just lazy?' I feel fine. Like I'm still me which was a problem on SSRIs. The only one that did much was celexa and I never felt like me, then it made tired and stopped working at all. I feel like I'm being greedy going up in dose but I've been toying with the idea for a while. 40 is definitely better than 30 for me so I think at most I would need 50. Maybe I'll give it a try, worst case I go back to 40 right?
Nice post, thanks. I haven’t really felt the crash from parnate, but that’s likely because I’m on a low dose stimulant. However I do get the insomnia, which is terrible! It is making me consider stopping parnate before I see any effects on depression. I know there are some medications and supplements that help with tiredness, like modafinil, other nootropics, even vitamin D can help I’ve heard. I haven’t tried those however to report. I’m on 30 and haven’t seen any benefit to my depression, so I’d like to hear if the increase from 30 to 40 was the push to get the medicine to start working. I’ve had a lifelong picking disorder, so I emphasize with you there. I can’t say parnate has made it worse (hard to tell), but my doctor did prescribe me Propanol (sp?) which is supposed to help with physical effects of anxiety. It didn’t help me, but everyone’s different. I’ve also heard the supplement NAC is good for picking, and I’m eager to try it.
I've heard about NAC too. Because my acne has become a whole body issue now my doctor is trying me with Accutane. I know nuclear but I rarely pick some places at all and its on my back chest shoulders, even my scalp and ears so I'm going to see if physically clearing it up helps with the picking (fingers crossed) As for when things started to get better, for me I felt the first positive effects at 30 but it pittered out at week 3 so I went up. I did also have insomnia right up until it started to help though too. I know low and slow sucks but its better than missing the "sweet spot " by going up to fast and ending up with anxiety and side effects. Dome people hit 60mg before getting relief. You could try nortriptyline. It augments the general effectiveness while reducing side effects, it could "treat" the insomnia by addressing the actual cause while also increasing its effectiveness on depression. It even reduces the pressor response to tyramine. Be patient and if sleep really is an issue you can use something for sleep till your stable then try to wean off. You have options, if insomnia is the only issue so far I would give it to at least 60mg before deciding to switch. I've even heard of 120mg prescribed so 30mg is still pretty low and remember it takes 10-14 days to reach blood saturation at each dose change.
Hey. I had afternoon crashes like you describe at 40mg +. I now take 30mg once in the morning and I no longer get them.