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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by FrequentFryer on February 17, 2009, at 16:13:38
Have you ever started off on a lowish dose of Phenelzine then increased the dose and notice any benefits?
Ever thought About Taking Phenelzine then when it poops out merge to Parnate, Ever Tried adding Selegelinge to Nardil...
Or anystuff like that.
Sorry if I'm being a bit personal.
Posted by FrequentFryer on February 17, 2009, at 16:17:06
In reply to HEY SLS!!, posted by FrequentFryer on February 17, 2009, at 16:13:38
My Psychiatrist reckons its ok to add or merge to MAOI's, then I heard from another smart dude it's ok if the MAOI's don't compete,,, (for serotonin eg.
> Have you ever started off on a lowish dose of Phenelzine then increased the dose and notice any benefits?
>
> Ever thought About Taking Phenelzine then when it poops out merge to Parnate, Ever Tried adding Selegelinge to Nardil...
> Or anystuff like that.
>
>
> Sorry if I'm being a bit personal.
Posted by SLS on February 21, 2009, at 8:13:12
In reply to Re: HEY SLS!! » FrequentFryer, posted by FrequentFryer on February 17, 2009, at 16:17:06
How silly of me not to notice your posts to me. You couldn't have made it more obvious.
You are not being too personal with me.
I have indeed tried starting out with Nardil very gradually. I once started at 7.5mg and moved up very slowly. It still turned out that 75mg was the absolute minimum that would produce an improvement. 90mg works better for me.
I have never actually seen someone combine Nardil with Parnate, although it has been a very alluring idea to me. I have never met a doctor who would allow such a thing. The ideas you present are interesting. I guess the thing that would still dissuade me from trying it is that a doctor of mine at NYU saw a case of someone having a fatal stroke after waiting only 10 days between discontinuing Nardil and starting Parnate. Was it an unrelated coincidence? I don't know.
I really appreciate your concern and the ideas you presented.
Thanks.
- Scott
Posted by desolationrower on February 21, 2009, at 9:29:53
In reply to Re: HEY SLS!! - I am profusely sorry! » FrequentFryer, posted by SLS on February 21, 2009, at 8:13:12
> How silly of me not to notice your posts to me. You couldn't have made it more obvious.
>
> You are not being too personal with me.
>
> I have indeed tried starting out with Nardil very gradually. I once started at 7.5mg and moved up very slowly. It still turned out that 75mg was the absolute minimum that would produce an improvement. 90mg works better for me.
>
> I have never actually seen someone combine Nardil with Parnate, although it has been a very alluring idea to me. I have never met a doctor who would allow such a thing. The ideas you present are interesting. I guess the thing that would still dissuade me from trying it is that a doctor of mine at NYU saw a case of someone having a fatal stroke after waiting only 10 days between discontinuing Nardil and starting Parnate. Was it an unrelated coincidence? I don't know.
>
> I really appreciate your concern and the ideas you presented.
>
> Thanks.
>
>
> - Scotti'm not sure the combination woudl be too effective, since it is the phenelzine metabolite from MAO metabolism that is responsible for gabatransimerase inihibition. i think adding a stimulant to nardil a better combo, although i don't think we can be too sure it wouldn't have some unknown benefit.
-d/r
Posted by SLS on February 21, 2009, at 9:54:38
In reply to Re: HEY SLS!! - I am profusely sorry!, posted by desolationrower on February 21, 2009, at 9:29:53
> since it is the phenelzine metabolite from MAO metabolism that is responsible for gabatransimerase inihibition.
Thanks. I did not know that it was the metabolite that is responsible for the increase in GABAergic neurotransmission.
I can't help but to want to recommend adding either desipramine or nortriptyline to an MAOI for treatment-resistant cases because of my continual success with this combination.
- Scott
Posted by myco on February 21, 2009, at 12:11:46
In reply to Re: HEY SLS!! - I am profusely sorry! » desolationrower, posted by SLS on February 21, 2009, at 9:54:38
Hey,
In support of the idea of adding/combining the TCA's desipramine or nortip (even though fiercely opposed by many dr's due to supposed "absolute contraindications") I offer the following study (in support of) that shows benefit and safety in this combination (MAOI + TCA):
"Tricyclic antidepressant pharmacology and therapeutic drug interactions updated"from abstract: "The data indicate that nortriptyline and desipramine have the most pharmacologically desirable characteristics as noradrenaline reuptake inhibitors (NRIs), and as drugs with few interactions that are also safe when coadministered with either MAOIs or SSRIs."
see link for full free paper:
http://www.nature.com/bjp/journal/v151/n6/pdf/0707253a.pdf
keep smilin,
myco> I can't help but to want to recommend adding either desipramine or nortriptyline to an MAOI for treatment-resistant cases because of my continual success with this combination.
>
>
> - Scott
Posted by SLS on February 21, 2009, at 18:32:06
In reply to HEY SLS!! - [MAOI/TCA is ok and supported - study] » SLS, posted by myco on February 21, 2009, at 12:11:46
> http://www.nature.com/bjp/journal/v151/n6/pdf/0707253a.pdf
>
>
> keep smilin,
I will.:-)
Thanks for posting the link, Myco.
- Scott
Posted by JadeKelly on February 21, 2009, at 18:35:11
In reply to HEY SLS!! - [MAOI/TCA is ok and supported - study] » SLS, posted by myco on February 21, 2009, at 12:11:46
Hi Scott,
Did you ever take Parnate with just a stim (maybe ritalin or somthing similar) without a tca? Or all three where dose of tca or Stim is major player ex: Parnate 80mg + Ritalin 60mg + Small dose of desiprimine OR P80mg + good size dose desiprimine + Small dose stim/rit ?
Don't need to change right now but wondered what you have done in the past. It took years for me to grow tolerance to 15mg day ritalin (for add) and I'm taking 60mg with Parnate. Not worried.
Thanks!
~Jade
Posted by SLS on February 21, 2009, at 18:51:21
In reply to Re: SCOTT, posted by JadeKelly on February 21, 2009, at 18:35:11
> Hi Scott,
Hi Jade
> Did you ever take Parnate with just a stim (maybe ritalin or somthing similar) without a tca?
Once. Parnate + Ritalin. The Ritalin didn't help me. Dexedrine helps me more than Ritalin.
> Or all three where dose of tca or Stim is major player ex: Parnate 80mg + Ritalin 60mg + Small dose of desiprimine OR P80mg + good size dose desiprimine + Small dose stim/rit ?
It has been my experience that combining a TCA with an MAOI does NOT reduce the need for a full therapeutic dose of the tricyclic.
> Don't need to change right now but wondered what you have done in the past.
Developing contingency plans. Good thinking.
I always felt better having alternative treatments mapped out well ahead of time.
- Scott
Posted by JadeKelly on February 22, 2009, at 0:30:28
In reply to Re: SCOTT » JadeKelly, posted by SLS on February 21, 2009, at 18:51:21
> > Hi Scott,
>
> Hi Jade
>
> > Did you ever take Parnate with just a stim (maybe ritalin or somthing similar) without a tca?
>
> Once. Parnate + Ritalin. The Ritalin didn't help me. Dexedrine helps me more than Ritalin.
>
> > Or all three where dose of tca or Stim is major player ex: Parnate 80mg + Ritalin 60mg + Small dose of desiprimine OR P80mg + good size dose desiprimine + Small dose stim/rit ?
>
> It has been my experience that combining a TCA with an MAOI does NOT reduce the need for a full therapeutic dose of the tricyclic.
>
> > Don't need to change right now but wondered what you have done in the past.
>
> Developing contingency plans. Good thinking.
>
> I always felt better having alternative treatments mapped out well ahead of time.
>
>
> - ScottThank you Sir Scott ;-)~
~Jade
This is the end of the thread.
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