Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Sleeplessness While On Parnate?
Question: Hello Dr,
I have been taking my Parnate at night because of the daytime sedation, and not sleeping well unfortunately. My doctor doesn't like me using ambien, so he gave me gabapentin for sleep.
shortly after taking gabapentin, the zoned-out, weakness, and sedation from the Parnate went away. I was so awake! It was my first day at 40 mgs but I had already gone through the stimulant feeling and sunk into the sedated part. I know something changed because I got up to urinate and nearly fell over with hypotension.
Is it possible that the gabapentin negated some of the sedated, apathetic qualities of the parnate, or is it coincidence and the increased dose kicked in? Typically Lamictal will keep me awake if I am on a serotonergic antidepressant and take it too late in the day. Maybe there was an additive effect with the lamictal and gabapentin?
In either case, it did not make me tired at all. I needed a full ambien and .5 mgs klonopin to put me to sleep. I'm not sure if all this combine GABA activity is safe.
I have been taking my Parnate at night because of the daytime sedation, and not sleeping well unfortunately. My doctor doesn't like me using ambien, so he gave me gabapentin for sleep.
shortly after taking gabapentin, the zoned-out, weakness, and sedation from the Parnate went away. I was so awake! It was my first day at 40 mgs but I had already gone through the stimulant feeling and sunk into the sedated part. I know something changed because I got up to urinate and nearly fell over with hypotension.
Is it possible that the gabapentin negated some of the sedated, apathetic qualities of the parnate, or is it coincidence and the increased dose kicked in? Typically Lamictal will keep me awake if I am on a serotonergic antidepressant and take it too late in the day. Maybe there was an additive effect with the lamictal and gabapentin?
In either case, it did not make me tired at all. I needed a full ambien and .5 mgs klonopin to put me to sleep. I'm not sure if all this combine GABA activity is safe.
Brief Answer:
It is safe
Detailed Answer:
Dear XXXXXXX
Thanks for folow up.
Regarding your doubts about the likely result of combination I like to inform you that it was (most) probably gabapntin which took your sedation away resulting in super alert state. I must also inform you that this is not the typical effect of gabapentin but such effects are observed in few patients taking MAO inhibitor medications such as parnate. I have not seen any such patients but got confirmed from one of my colleague who had such patients in past.
Regarding the safety of this combination I must again assure you that increased serotonin level resulting in serious serotonin syndrome as a rule takes place in 48 hours and you are currently in safe side. The combination is routinely used during initial phase of treatment.
Once the proper effect of parnate kicks in we can think of stopping gabapentin at earliest.
I hope this answers you further.
Thanks and regards.
It is safe
Detailed Answer:
Dear XXXXXXX
Thanks for folow up.
Regarding your doubts about the likely result of combination I like to inform you that it was (most) probably gabapntin which took your sedation away resulting in super alert state. I must also inform you that this is not the typical effect of gabapentin but such effects are observed in few patients taking MAO inhibitor medications such as parnate. I have not seen any such patients but got confirmed from one of my colleague who had such patients in past.
Regarding the safety of this combination I must again assure you that increased serotonin level resulting in serious serotonin syndrome as a rule takes place in 48 hours and you are currently in safe side. The combination is routinely used during initial phase of treatment.
Once the proper effect of parnate kicks in we can think of stopping gabapentin at earliest.
I hope this answers you further.
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Kampana
it did not repeat yesterday. I took the 40mgs of Parnate and was dead on my feet all day. I took gabapentin again to see if the sedation resolved and it did not.
I am done with Parnate. I am not sleeping or eating, weak, and tired all the time, and when it kicks in I feel unsocial and motivated. I took it for 17 days, the last two at 40 mgs. What recommendations do you have for stopping?
I am done with Parnate. I am not sleeping or eating, weak, and tired all the time, and when it kicks in I feel unsocial and motivated. I took it for 17 days, the last two at 40 mgs. What recommendations do you have for stopping?
Brief Answer:
Follow up
Detailed Answer:
Dear XXXXXXX
Thanks for follow up.
I am sorry to know that parnate failed to act in any regard except side effects.
I know it is very difficult to decide against or in favor but I feel your decision is right at this stage.The two essential criteria 1.Intolerable side effects and 2. No or minimal effect are applicable in your case and it is time to call a good buy to parnate.
Regarding withdrawal go in this way
From today 20 mg per day
From 17th May 10 mg per day and stop it by 21 May.
I am giving you the practical suggestion as slow withdrawal after 17 days is not necessary and even the above schedule unlikely to cause any serious withdrawal symptoms.
I hope this answers you.
Thanks and regards.
Follow up
Detailed Answer:
Dear XXXXXXX
Thanks for follow up.
I am sorry to know that parnate failed to act in any regard except side effects.
I know it is very difficult to decide against or in favor but I feel your decision is right at this stage.The two essential criteria 1.Intolerable side effects and 2. No or minimal effect are applicable in your case and it is time to call a good buy to parnate.
Regarding withdrawal go in this way
From today 20 mg per day
From 17th May 10 mg per day and stop it by 21 May.
I am giving you the practical suggestion as slow withdrawal after 17 days is not necessary and even the above schedule unlikely to cause any serious withdrawal symptoms.
I hope this answers you.
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you. I am a little worried that I am not giving it a chance.
In addition to sedation etc., there is a mental effect I find very uncomfortable: It quiets everything out of my mind and leaves me with this singular, neurotic, stream of consciousness focused on my medication/state.
If I take ritalin it helps to "externalize" my thinking if that makes any sense, otherwise I feel like I'm living in a deprivation chamber. Similarly, when people speak to me, they seem so removed. Nortriptyline, wellbutrin, and a handful of other meds felt like this. I'm wondering if it's how I react to NE stimulation but that's probably an oversimplification. Either way I don't expect this to subside I'm guessing it's probably a therapeutic effect.
Does this seem like a fair evaluation?
In addition to sedation etc., there is a mental effect I find very uncomfortable: It quiets everything out of my mind and leaves me with this singular, neurotic, stream of consciousness focused on my medication/state.
If I take ritalin it helps to "externalize" my thinking if that makes any sense, otherwise I feel like I'm living in a deprivation chamber. Similarly, when people speak to me, they seem so removed. Nortriptyline, wellbutrin, and a handful of other meds felt like this. I'm wondering if it's how I react to NE stimulation but that's probably an oversimplification. Either way I don't expect this to subside I'm guessing it's probably a therapeutic effect.
Does this seem like a fair evaluation?
Brief Answer:
Yes it is fair
Detailed Answer:
Hello,
Thanks for follow up.
Feeling of staying in deprivation chamber is well known side effect of parnate and I do not think you are wrong in this regard.
Regarding NE stimulation I would like to say that it is not so simple to clear our doubts as inside the brain the medication acts very differently and not known to human kind completely. It can be said that it cuts off you from all emotions leading to such side effects.
As stated above I prefer withdrawal of parnate due to poor effect and strong side effects.
I hope this helps you.
Thanks and regards.
Yes it is fair
Detailed Answer:
Hello,
Thanks for follow up.
Feeling of staying in deprivation chamber is well known side effect of parnate and I do not think you are wrong in this regard.
Regarding NE stimulation I would like to say that it is not so simple to clear our doubts as inside the brain the medication acts very differently and not known to human kind completely. It can be said that it cuts off you from all emotions leading to such side effects.
As stated above I prefer withdrawal of parnate due to poor effect and strong side effects.
I hope this helps you.
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you for listening
Brief Answer:
You are always welcome
Detailed Answer:
Dear XXXXXXX
This is my pleasure to assist the suffering individuals at the most crucial point of time when even the regular services are not available.
Thanks and regards.
You are always welcome
Detailed Answer:
Dear XXXXXXX
This is my pleasure to assist the suffering individuals at the most crucial point of time when even the regular services are not available.
Thanks and regards.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
