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Desperation -- even with (whoo!) Parnate

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Hi, everyone. I looked for an existing thread to hook this to but could not find one.


Ths short story is after trying everything except TCAs other than desipramine I forced my shrink to prescribe Parnate. I take 60 mg/d. It only works when augmented with an SGA (currently using Fanapt). I have the typical sleep fragmentation. I'm not in abyss-mode but I'm so, so sad--it's like the Parnate facilitates the movement of sadness and desperation through me, so I cry all the time. Hell, I was watching reruns of "Friends" and crying at *those.*


While I am somewhat preserved from total anhedonia I have almost complete anergia. I cannot do anything except surf the web and go to doctor's appointments. The government provides a "homemaker" to come for two hours per week and that is a godsend--having her here helps to motivate me to clean alongside her.


The pdoc and therapist have prescribed a dog (an "emotional support animal") to help with my loneliness and isolation, which is crushing.


So I take the 60 mg Parnate, 8 mg Fanapt, 150 mg lamotrigine, and 4 mg clonazepam. I would dearly love to go back on Adderall but it's contraindicated with Parnate (though many pdocs use it) but it makes my blood pressure soar.


We are looking into Provigil (modafinil) as a means to prevent the absolute necessity of taking a three-hour nap every afternoon.


My pdoc mentioned marijuana, which is medically legal in Massachusetts, my home state. Maybe ... in greater than moderate doses it takes away my motivation even more, but in low doses it might help with the anxiety and the tears.


Could I raise the lamotrigine? Sometimes switching the atypical works for a bit--I've also had success with Seroquel, Latuda, and Zyprexa. The problem is that Seroquel and Zyprexa make me eat like a fiend.


Ideas, ideas?

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You certainly have plenty of room to go up on the Lamictal (with your pdoc's approval). I'm guessing that you have tried Abilify and Geodon among the antipsychotics you have taken. I didn't have much luck with Provigil, but it is certainly worth trying if it is not contraindicated by the Parnate.


I'd stay away from weed if I were you. It can have bad consequences for us who suffer from brain malfunctions. I find it somewhat strange that your pdoc would bring it up as most pdocs would tell you an emphatic "No!" Of course, this is my opinion, and I'm certainly no doctor.


Have you tried lithium or any of the anticonvulsants (other than Lamictal)? Tegretol helps me an awful lot. However, I believe that Tegretol is contraindicated with Parnate. Lithium is often used as an augmentation strategy in cases of refractory depression. Again, I don't know if it is contraindicated with Parnate.


I don't know what is worse: being able to feel emotions and feel sadness, or having your emotions numbed out. My SSRI numbs my emotions so much and takes away my ability to cry even when I feel like I need to.

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I don't have additional pharmaceutical advice on top of what's already been said, but wanted to say hello from neighboring Rhode Island and say I'm sorry you're feeling so crappy.  Pets are an amazing support: my cats have saved my life.  Your pdoc's recommendation sounds like a great one if you are able to provide care for an animal.  I hope you start feeling better soon.

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parnate also made me very emotionally labile, as you described.  i had to raise both my lithium and my lamotrigine while i was taking it.  i also did smoke mj to turn the waterworks off when i was desperate for relief.  but that can have unintended side effects too.  also the more clonazepam i took, the more irrational crying i did, which was really hard to deal with, so i stopped taking it completely for awhile and that sucked.

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