Posted by Tomatheus on December 15, 2006, at 1:26:34
In reply to Nardil+Bupropion Guinea pig, posted by tecknohed on December 11, 2006, at 15:01:27
Hi Tecknohed,
I'm sorry to hear that your condition has worsened since you posted here last. The optimist in me was hoping that you were still responding favorably to the Nardil-pregnenolone combo that you tried taking around this time last year, but I somehow had the feeling that your response to pregnenolone would unfortunately turn out to be similar to mine (a few days of relief, followed by a return to my baseline state of severe depression).
It's good to hear from you, though, despite the circumstances. And it's encoraging to hear that you're trying different medication combos. I hope that combining Wellbutrin with Nardil will give you the lift that you need to begin functioning somewhat normally again. I can certainly relate to not having the energy to do much of anything, despite trying one treatment strategy after another, and despite making every effort to try to get out of bed and accomplish all (or even a few) of the things that I want to accomplish. So, unfortunately, I know that you're not exaggerating when you say that the extreme fatigue that you've been feeling is hell to live with. And I know that it's generally not recommended to take phenelzine (Nardil) in combination with bupropion (Wellbutrin, Zyban). In fact, as you probably know, the two meds are technically contraindicated. But some cases of depression are more disabling and treatment-resistant than others, and I wouldn't rule out the possibility that you might have a sort of double depression that *requires* the use of an antidepressant combo that might be considered to be "dangerous" in some individuals.
I haven't personally tried taking Nardil in combination with Wellbutrin (or Zyban or generic bupropion), and I'm not sure whether or not anybody who's posted on this board recently is currently on the combo. I know that Ace was thinking about adding Wellbutrin to his medication cocktail (which of course includes Nardil, considering that he's the "Nardil champ"), but I'm don't know for sure whether or not he ultimately ended up taking the Wellbutrin.
Finally, I am not aware of any reports describing the successful combination of phenelzine and bupropion in the peer-reviewed medical/scientific literature. However, I do have one case report in my possession (Pierre & Gitlin, 2000) that summarizes one woman's "gradual return to euthymia with resolution of her long-standing depressive symptoms" following the administration of a bupropion-tranylcypromine (Wellbutrin-Parnate) combo -- 300 mg/day of bupropion and 60 mg/day of tranylcypromine. Attempts to discontinue either the bupropion or the tranylcypromine resulted in a return of the woman's depressive symptoms. The report's authors emphasized the potential benefits of the cautiously prescribing a bupropion-tranylcypromine combo to individuals with treatment-resistant depression. Considering that Parnate (tranylcypromine) is both an MAOI and a monoamine reuptake inhibitor whereas Nardil (phenelzine) is not known to possess any reuptake inhibitory properties, it would be my guess that a Wellbutrin-Nardil combo should be at least as safe as a Wellbutrin-Parnate combo. Whether or not a Wellbutrin-Nardil combo would be as effective as a Wellbutrin-Parnate combo is difficult to determine.
Thanks for posting again. I hope that you might find my response to be of some help.
Tomatheus
==
REFERENCE
Pierre, J. M., & Gitlin, M. J. (2000). Bupropion-tranylcypromine combination for treatment-refractory depression. Journal of Clinical Psychiatry, 61, 450-451.
==
> Hi people. Special Hi to those who remember me (& who I didn't p*ss off in some way).
>
> Haven't posted here for nearly a year. Things have got worse than ever since then.
>
> Main symptoms are still Social Phobia/APD, up & down severe depression plus a fatigue LIKE I NEVER THOUGHT POSSIBLE. Dont know WHAT the fatigue is all about. I'm hoping it's a side effect of long term modafinil use & not something worse, though I have my suspicions. I've always had energy problems but this really worries me & is hell to live with.
>
> Still on Nardil - have been for 3 years. On very low dose of Clonazepam, not cause it helps but rather because I 'need' it. Without it I feel hectic inside. And I just come to end of modafinil - I've concluded that it aint no long term solution, not for me. But I have to stop it anyway as my pdoc has just gone ahead & issued me a script of Zyban (UK Bupropion - recently licenced here as an antidepressant, incidently). Not even I would mix the 2.
>
> Anyway, its what I've asked for for ages & all I've ever got is refusals with some sort of explination of how it would be too dangerous with Nardil. In fact My pdoc has told me in the past he'd never even heard of such a combo. Funny how today he said he'd tried it on a few patients combined with MAOIs. Said it may be worth a try, like it was all his idea (I plan to change my doc again soon!).
>
> So who's got any comments on this combo of Nardil & Zyban/Wellbutrin? Whos tried it, knows someone who has, read something about it, etc etc etc...? I can't find any info anywhere.
>
> I've taken my 1st quarter pill but no problems so far...
>
> All responces appreciated.
poster:Tomatheus
thread:712640
URL: http://www.dr-bob.org/babble/20061212/msgs/713844.html