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Re: Ame Sans Vie, Nardil + Tramadol? suggestion » temoigneur

Posted by Ame Sans Vie on January 21, 2004, at 2:12:52

In reply to Ame Sans Vie, Nardil + Tramadol? suggestion » Ame Sans Vie, posted by temoigneur on January 19, 2004, at 1:03:34

> Hi Michael, How are you, good to see you again.

Hi there, it's been a while! I just returned to the boards after a bit of a break.

>I don't think we've talked since we've I started nardil. What's happening is last time I was on Nardil and tried to come off zyprexa, my OCD came back with a vengeance. Do I remember correctly you saying that tramadol could work brilliantly for OCD/anxiety as long as you took a substance like DMX to ward off tolerance.

Tramadol can definitely be one of those elusive miracle drugs for OCD, but combining it with an MAOI would certainly be tricky business... though I do believe it could be done (see my post to Ace further down on the board re: tramadol + MAOIs). And just to avoid confusion, the cough suppressant that helps prevent tolerance to various drugs is DXM (dextromethorphan), not DMX. :-)

> I was wondering if you knew of any opiate drug that wouldn't be contraindicated, or has at least a reasonably safe track record in combination with MAOI's. I have OCD, SP, GAD, and PD. I'm getting a new pdoc who doesn't have a problem with perscribing trazodone with MAOI's, as I have insomnia on it. Convincing him to let me try a narcotic will be a feat

A feat? lol What a master of understatement that you are. ;-) Really though, it just takes having an open-minded doctor and bringing in information to prepare him/her for the possible addition of an opioid drug. Easier said than done, I know. lol

Many opioids have safely been taken with MAOIs. Morphine, codeine, hydrocodone, hydromorphone, methadone, butorphanol, pentazocine, buprenorphine, levomethorphan, oxycodone, oxymorphone, and fentanyl are among those which have safely been used with MAOIs in the past. The primary ones to avoid are Demerol (meperidine/pethidine), obviously, and the opioid anaesthetics (i.e. alfentanil, sufentanil, remifentanil).

If your doctor is willing to experiment, I'd suggest keeping buprenorphine (Subutex/Suboxone) in mind, as it seems to help plenty of people with depression without significant development of tolerance. And it seems that all opioids can be useful for OCD, so surely bupe could help.

> Is your current combination working for you? Do you mind me asking what your diagnosis is again.

It's working great, thanks for asking! My primary diagnoses are social anxiety disorder, avoidant personality disorder, panic disorder, depression, and agoraphobia, and I also have mild-moderate symptoms of both OCD and ADD. I'm taking 8mg/day Klonopin, 60mg/day Adderall XR, and 20mg/day Prozac; then there's also the one gram Somnote and 200mg Tuinal that I switch back and forth between for sleep when needed, though I haven't needed them much lately.

> I'm writing you today because my OCD is bound to come back tomorrow or the next day, as I've cut back on the zyprexa. It can be difficult to write and look for help with my OCD as it is always telling me that I must go through emotionally draining rituals before I am worthy of asking for help and if I don't I risk having a panic attack so I thought I'd write you today when I'm cognizant enough that I can get something across, but my zyprexa has not worn off to the point where it becomes hard.

I'm sorry it took me a few days to respond -- my computer was acting up on me. I hope this can help, and if you'd like to e-mail me, the address is amesansvie@yahoo.com.

Michael


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poster:Ame Sans Vie thread:298512
URL: http://www.dr-bob.org/babble/20040118/msgs/303571.html