Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Severe Depression Despite Medication
Question: Hi, I am currently taking 80 mg of parnate.(40 mg bd), also 10 mg of propanol XXXXXXX and 25 mg imediate release serequol XXXXXXX and 75 mg note. Over the last month my mood has decreased dramatically, I don't wanto do anything to see anyone, i am expressionless and am very down. I am wanting to know if I can increase my parnate dose to 90mg and see if this help? Thank you
Brief Answer:
I think it can be done provided you are able to tolerate
Detailed Answer:
Dear XXXX,
Thanks for using Healthcaremagic.
I read your query and understand your concerns.
As you might be knowing that maximum recommended dose of Parnate is 30 mg twice a day and you are already taking 80 mg per day.
Although the recommendations do not allow me to advice you to increase dose but I think it can be done provided there are no limiting side effects. There are some case reports of using it upto 100 mg without any significant side effect burden. So yes you can increase but take care of side effects and talk to your psychiatrist.
As I can see there is evidence of treatment resistant depression ask your psychiatrist to increase the dose of seroquel to slightly higher. Recently I had two patients who responded to only seroquel despite having multiple failure with other antidepressants. In my view target the seroquel dose in the range of 150 to 300 mg total per day in addition to antidepressants. I understand that it is not fool proof but there is chance of response.
I hope this helps you.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
I think it can be done provided you are able to tolerate
Detailed Answer:
Dear XXXX,
Thanks for using Healthcaremagic.
I read your query and understand your concerns.
As you might be knowing that maximum recommended dose of Parnate is 30 mg twice a day and you are already taking 80 mg per day.
Although the recommendations do not allow me to advice you to increase dose but I think it can be done provided there are no limiting side effects. There are some case reports of using it upto 100 mg without any significant side effect burden. So yes you can increase but take care of side effects and talk to your psychiatrist.
As I can see there is evidence of treatment resistant depression ask your psychiatrist to increase the dose of seroquel to slightly higher. Recently I had two patients who responded to only seroquel despite having multiple failure with other antidepressants. In my view target the seroquel dose in the range of 150 to 300 mg total per day in addition to antidepressants. I understand that it is not fool proof but there is chance of response.
I hope this helps you.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your input. I have to wait a month to see a new psch as mine recently moved away. I have been on high doses of serequol previously and XR at 600 mg the serequol that I take now it to help anxiety and sleep, was increased to 75 nocte a couple of months as I was becoming tolerant to the 50mg. I currently take 40mg in the morning and 40 at 2pm. Should I take the extra 10mg in the morning or afternoon? Thanks
Brief Answer:
In the morning
Detailed Answer:
Dear XXXX,
Thanks for reverting back to me.
It should be added with morning dose of Parnate as it is activating medication.
In view of the additional information with seroquel experience I think we need to target Parnate on this day.
I hope this helps you.
Thanks and regards.
In the morning
Detailed Answer:
Dear XXXX,
Thanks for reverting back to me.
It should be added with morning dose of Parnate as it is activating medication.
In view of the additional information with seroquel experience I think we need to target Parnate on this day.
I hope this helps you.
Thanks and regards.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
