parnate has been a life saver for me. that said, i am lucky in that i only have to be on 15mg.
found this info for you:
Quote:
Safety of high-intensity treatment with the irreversible monoamine oxidase inhibitor tranylcypromine in patients with treatment-resistant depression.
Adli M, Pilhatsch M, Bauer M, Köberle U, Ricken R, Janssen G, Ulrich S, Bschor T.
Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany. mazda.adli@charite.de
INTRODUCTION: Because the irreversible monoamine oxidase inhibitor tranylcypromine (TCP) was introduced nearly 50 years ago, only few studies exist on today's clinical prescribing practice together with 2nd and 3rd generation psychotropic drugs. METHODS: We performed a practice-based observational study of patients with depression treated with TCP in two psychiatric departments in Berlin to assess side effects, effectiveness, comedication and acceptance of the low-tyramine diet. RESULTS: We identified thirty-two patients treated with TCP at a mean dose of 51.9 mg/day after an average of 3.3 pre-treatments in the current episode. Dosing of TCP and the use of multiple psychotropic comedications indicate a high-intensity treatment. The most frequent side effects resulted from arterial hypotonia (28%). Dietary restrictions were mainly rated as moderate. 59% of patients remitted (HAMD- (21)<9 or CGI-I=1) and 22% responded (HAMD- (21) reduction >50% or CGI-I=2). DISCUSSION: A high-intensity treatment of inpatients with TCP is clinically feasible, i.e., the use of high doses and multiple comedications with a good benefit-risk-ratio. Prospective data aiming at comparisons with modern antidepressants and clarifying further safety issues are warranted.
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so from what i'm reading, if the average dose was ~59mg, then other ppl have also gone up higher.
but looking at the combo you are on - parnate, abilify and lamictal are all activating drugs. if sleep is a problem for you, it would make better sense (to me) to reduce the dosage of the other drugs a bit to help get the sleep back on track. i have always functioned better when ive been able to maintain my own sleep cycles without the use of medication for that. i dont know - maybe it's just me - but sleep whilst on sleeping pills feels very different to natural sleep.
i would encourage you to talk to your doc about your concerns, however. i've been on higher than recommended clinical maximum doses before without ill effects, but eventually we've decided that if i need to go that high then maybe a different drug would be more beneficial instead. that's how i came across parnate.