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Re: substitute for APs » nellie7

Posted by Chairman_MAO on February 28, 2006, at 22:31:24

In reply to substitute for APs, posted by nellie7 on February 25, 2006, at 11:09:28

Your best bet would be methylphendiate or d-amphetamine + clonazepam (2mg/day to start). The clonazepam's dose is an educated guess based upon the dose it takes to suppress LSD flashbacks or "abort" a trip (in most cases). Psychostimulants at low doses tend to "ground" people who aren't psychotic.

You can try this with or without the SSRI, but I doubt you'd need the SSRI if you had the above two drugs (d-amphetamine is better for anxious states).

For monotherapy, I'd go with phenelzine 1mg/kg. There are at least case reports somewhere which detail the use of MAOIs for this perplexing disorder. A third-line combo would be phenelzine+[d-amphetamine]+[clonazepam]+lamotrigine.

There's tons of other stuff you can try, most of it no good. My personal opinion is that if you brought the clonazepam dose up high enough (['m talking 5-20mg/day in divided doses) and then started galantamine to keep your cognitive abilities and to counteract the sedation, your problems would be gone right there. Galantamine virtually eliminates any trace of benzodiazepine memory impairment, thought cloudiness, muscle overrelaxation, sedation, etc. There is bulgarian research I have read in the USPTO about that treatment algorithm. Normally, benzodiazpeines inhibit the release of acetylcholine; the galantamine compensates for this.

Have you ever gotten your HPTA axis checked out? Levels of hormones, etc? HPTA dysregulation is often present with that disorder.


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