Posted by SLS on December 17, 2006, at 6:22:55
In reply to Scott how did you come up with this combo?, posted by UgottaHaveHope on December 16, 2006, at 23:36:31
> What is the logic behind it? Nardil alone, wouldnt work? What do the other drugs do? It makes my day to hear that you are feeling better. Michael
Well, MAOIs alone have produced only partial responses at best. TCAs have produced either robust brief responses or persistent partial responses when combined with Lamictal. The only thing that ever got me well was a combination of Parnate + desipramine in 1987. Unfortunately, that combination was errantly discontinued and doesn't work anymore. Fortunately, despite concerns regarding the induction of serotonin syndrome, I was able to convince my doctor to go along with the Nardil + nortriptyline combination. Fortunately, I had already tried Parnate + nortriptyline with him, so it was hard for him to say no. Now, all I have to do is to convince him to raise the dosage to 90mg in a few weeks if necessary.
For now, I would say that the two main TCAs to avoid with Nardil are imipramine and clomipramine. Desipramine and nortriptyline seem safe.
I'm not sure I answered your question. I guess a TCA won't work if there isn't enough neurotransmitter around that an inhibition of reuptake would significantly increase synaptic concentrations. An MAOI would help provide an increase in the amount of neurotransmitter available by preventing its breakdown.
- Scott
poster:SLS
thread:714163
URL: http://www.dr-bob.org/babble/20061217/msgs/714491.html