Posted by psychobot5000 on January 28, 2007, at 10:07:03
In reply to Re: EMSAM + Stimulants - is there any published da, posted by jealibeanz on January 27, 2007, at 14:17:56
> I thought CNS stimulants and Provigil are contraindicated with MAOI's.
According to the books and labeling guidelines, they are--no one wants someone else to die because of MAOi-related complications.
However, many docs experienced with MAOis consider stimulants safe enough to use carefully--start low on the dosing, go slow, and monitor blood pressure and heart-rate carefully. Since MAOis are frequently an antidepressant for the severely treatment-resistant, there is pressure to use things like stimulants that could be helpful augmentors. For many they seem to do the trick together, when nothing else will, including for some on this board.
Stims can also be useful for the low blood-pressure caused by MAOis (as mentioned above), and for other side-effects like afternoon sleepiness from Parnate, or lack of motivation and energy with Nardil. ...But since, if someone screws up, the patient could DIE, docs continue rightly to be very wary, and the labeling guidelines stay the same.
...However, provigil should be relatively much safer--there does not appear to
be the same risk of cardiac side-effects. Physician opinions seem to vary on that, but I've never heard of a dangerous incident caused by combining them.
poster:psychobot5000
thread:726595
URL: http://www.dr-bob.org/babble/20070125/msgs/727406.html