Posted by Questionmark on November 16, 2004, at 2:51:26
In reply to Re: The Forbidden Combination, posted by ed_uk on November 8, 2004, at 11:23:54
i have used *extremely* low-dose Paxil a few times while i have been on Nardil-- not by doctor's instruction, of course. i believe each time i was short on my Nardil for a couple days or so (though i think the first time may have been out of curiosity and the need for extra extra help with sociability and happiness that particular day).
(By the way, i know it goes without saying, but still-- this is NOT a good idea.)
Each time was roughly between 2.5mg and 5mg of Paxil (cut 10mg or 20mg pills), and i had been taking either 45mg or 60mg Nardil previously or presently. The effects of even this low dose of Paxil was profound: hypomania, euphoria, nervousness and excitability but not of the extremely unpleasant kind, moderate to more-than-moderate muscle tension and the desire to clench/contract muscles fairly hard, jaw clenching, obnoxious self-amusing behavior and speech (so to speak), increased body temperature, flushing, pupil dilation, and restlessness (e.g., my leg shaking even more rapidly than usual when sitting; exaggerated facial movements such as stretching mouth a lot and such). There certainly may have been a number of negative physiological effects that went unnoticed as well, such as excessive muscle protein breakdown (or something along those lines), kidney stress, and who knows what kinds of possiblly harmful brain effects?.
Anyway, i wanted to give my account so i could give my opinion on this matter and do so with a little added credence. i am really really open to the cautious use of oft-touted "contraindicated" med combinations. However, i fully believe that the combined use of an MAOI and an SSRI (any SRI probably) is never worthwhile. Aside from the significant danger and narrow margin of safety with efficacy, any desired effects that may be obtained from this combination can easily, safely, and still effectively be obtained via an increase in SSRI or MAOI dosage alone.
The reason i used the added Paxil was because i wanted an immediate effect for that particular day, but i'm foolish, desperate, overly curious, and Rx dependent (not any Rx in particular-- per se-- but Rxes in general). You get the idea.