Posted by SLS on January 4, 2007, at 9:00:33
In reply to Re: I lost myself » SLS, posted by Quintal on January 4, 2007, at 7:51:48
Hi Quintal.
> > I have always wondered how well augmenting Nardil with either Provigil or amisulpride would work.
> I have too. Is Nardil thought to be more dopaminergic than Parnate?Tough question. I have never seen anything written that states with confidence this to be true, but I wouldn't exclude the possibility. I find Nardil to be more of a "mood brightener" than Parnate with a greater increase in the experience of reward and enjoyment of activities. I happen to think that Nardil is a more potent MAO-A inhibitor than Parnate. I wouldn't discount the possibility that this is the result of either:
1. The localization of MAO inhibition different than Parnate.
2. An energizing or anhedonic property other than MAO inhibition.
3. A greater degree of MAO-A inhibition relative to Parnate, which would produce increases of dopamine in cortex and hippocampus.
> The patient information leaflet that comes with my generic tranylcypromine says it acts on both serotonin and noradrenaline.
I think that may be because dopamine was never considered by the pharmaceutical companies as important in the actions of antidepressant drugs. It is a bias in writing rather than a reflection of pharmacology.
> There's no mention of dopamine but I presume being an MAOI it has some effect on the dopamine system?
I'm pretty sure both Parnate and Nardil inhibit MAO-B enough to produce an increase in the concentration of dopamine in the LOCALITIES that the drug penetrates and the enzyme acts. MAO-A also acts to deaminate dopamine in various regions where MAO-B doesn't exist.
> I asked my pdoc if we could augment Parnate with amisulpride after he refused to raise the dose above 30mg.
30mg? <sigh of frustration>
I guess I don't need to tell you that the dosage effective range is more like 40-80mg. It doesn't sound like there is too much that will pursuade your doctor to change his mind. Have you brought in any literature for him to look at?
http://sl.schofield3.home.att.net/medicine/mao_inhibitors_option_trd.html
> He refused on the grounds that it would be too stimulating, but I think that could be an advantage with Nardil?
My guess is that it would not produce overstimulation beyond the first few days, if at all.
- Scott
poster:SLS
thread:718916
URL: http://www.dr-bob.org/babble/20070101/msgs/719223.html