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Re: Your_thoughts? » EERRIICC

Posted by SLS on February 22, 2005, at 17:00:57

In reply to Your_thoughts? » SLS, posted by EERRIICC on February 22, 2005, at 16:29:22

Hi Eric.

> I've read many of your posts and I am impressed with your knowledge and your insight into affective disorders. The fact that your illness has been refractory must be extremely frustrating.

Frustrating as hell.

> Did you try high dose Parnate yet?

I went up to Parnate 150mg + desipramine 300mg + Lamictal. I did feel a bit "brainier" for a little while, but this pretty much "pooped-out" after 3 months - similar to the time course you describe.

> 150mg a day got me through university,

What a blessing.

> but then stopped working.

MF

> After this it would work again for about three months if I took a couple months off in between. Any idea why Parnate does this, or how to prevent tolerance?

That's the big question. I'm looking for some ideas myself. I added memantine (Namenda), a non-competitive NMDA glutamate receptor antagonist that some people think can prevent tolerance to opioids and perhaps stimulants. I started taking Parnate just a few months ago. I'll let you know if I hit pay-dirt, but I am not expecting to. The preliminary indicators of a positive response that consistently appear for me have not at this point. I guess I don't want to get my hopes up. Then again, I've only been taking the memantine for 10 days or so. I sometimes go around in circles between optimism and despair when I'm trying something new.

> What are your views regarding NMDA antagonists to prevent amphetamine and opiate tolerance?

I think there is sufficient evidence that memantine can prevent tolerance to the nociceptive actions of opioids that it should be looked at more intensively. I haven't seen as much published regarding its effects on stimulants. I know one person who reports that memantine has worked wonders when added to Adderall.

I tried memantine over the summer when I was taking imipramine in the absence of an MAOI. I experienced a mild-moderate response to it that was somewhat episodic over the course of two weeks before it stopped working.

This is what I'm taking now to treat bipolar depression.

Parnate 70mg
nortriptyline 100mg
Lamictal 300mg
Abilify 10mg
memantine 20mg

The results so far are woefully inadequate. If I am pleasantly surprised by memantine + Parnate, you'll be the second to know! (I'll be the first)

:-)

> Have you ever heard of Deep Brain Stimulation (for depression)?

I've seen it do some miraculous things for Parkinsons Disease. It wouldn't surprise me if it had some utility in affective disorders. What have you read about it so far?


- Scott

 

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