Posted by janeS on June 28, 2000, at 18:28:47
In reply to Re: MAOI Diet Restrictions, posted by SLS on June 28, 2000, at 17:36:45
> Hi Jane.
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>
> What side effects in particular is your doctor concerned about?
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> What was your experience with Tofranil? Why did you discontinue it?
>
>One paper I read emphasized the effectiveness of combining Remeron with Effexor. Effexor plus Wellbutrin is another combination that I know can be effective when neither by itself is adequate. I think combining drugs that have already shown themselves to be partially effective is a good strategy. If Remeron helps, you may want to build combinations around it.
>
> If you need to get radical, yet remain safe, you can combine an MAO inhibitor with a tricyclic. I mention this because you have had success with both. I have taken Nardil and desipramine together, but responded only minimally. When combined, I experienced more postural hypotension (low blood pressure upon standing) and had trouble initiating urination. There is some thought that the tricyclic can actually provide a buffer against a tyramine (cheese) reaction. The only drug regimen that ever worked for me was a combination of Parnate and desipramine. Unfortunately, my doctor at the time had me discontinue this treatment in favor of Prozac, which had just been approved. It didn't work. When it finally came time to try the combination again, I failed to respond to it. Here I am.
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> Good luck. Please post.
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> * Does anyone know if Remeron can be combined with an MAO inhibitor safely?
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>
> - ScottScott:
Your info and insight is incredible! Thank you soooo much!!! The p-doc I see now is the first of two p-doc's in my story. First time I ever went to see a p-doc she prescribed Tofranil (10 years ago). I remained on that except for 1 pregnancy for 4 years. Long story short, had a car accident, many doctors, many meds...then the descent into a black pain-depression cycle...which led me to the 2nd p-doc who weaned me off EVERYTHING and eventually placed me on Nardil.
Longer story shorter, Nardil pooped out after 4 years, went BACK to the 1st p-doc (almost 2 years ago) who then began my current trial and error period with ALL SSRI's, Buspar, Effexor, Effexor + Serzone and then just Serzone.(Just wanting you to have the Complete history...)
Something you said points out something I don't do...I don't take things to the next step, meaning when I asked her about Nardil she responded with side effects...I didn't say, "Which ones/What are they?" I simply took her word for it. Same thing with Tofranil and she was the one who treated me originally with Tofranil. Hmmmm... I think you hit the nail on the head as far as her expertise with MAOI's. She most likely stays away from them. We, in about 6+ years altogether have never discussed them.
My next appt. is 2+ weeks away...and I'm thinking of asking about the Remeron/Wellbutrin SR combo. Also at that time I will quiz her about the MAOI/Tofranil thing again. I intend to also ask about the Marplan...that sounds appealing as well. I'm the type of 'anxious' person who really doesn't do change really well...so the combo is appealing, but with more info and more time, I may be able to take the leap in a few months. (That would give the combo test enough time.)
I'm so tired of not feeling well...I've seen daylight before and I know it's still there...in theory. I would also very much like to be the adult I am supposed to be and get on with my life. I was an HR Director whose company sold, corporate headquarters closed and I was offered a similar position in Austin, TX (I'm in Lexington, KY) but I didn't want to make the move...so the new company set me up to telecommute from home and I have done that since February...but that project has ended so I'm TRYING to look for a new job...but I feel like I need to get this under control first...and then find myself wondering if I would do better having a job...a reason to get up, dressed, exciting and rewarding work, etc. I guess I'm trying to fix the beast and it's all interelated. Any thoughts on THAT one???
So, what about you? Since your combo has not worked out well, what are you doing?
Scott, thanks so much for all of your help and if this is just more than you wanted to get into I understand...but as I said earlier, I admire your knowledge and insight.
Gratefully,
Jane
poster:janeS
thread:38324
URL: http://www.dr-bob.org/babble/20000619/msgs/38618.html