Posted by psychobot5000 on June 14, 2007, at 13:30:06
In reply to Re: Combining Provigil and Parnate » Tomatheus2, posted by gardenergirl on June 12, 2007, at 14:20:55
I wanted to mention that the MAOi specialist I had a consult with once stated during that meeting that he considered Provigil and Phenelzine or tranylcipromine (parnate) to be a -relatively- safe combination, and one that he recommended to deal with the sleepiness or fatigue that can be associated with MAOis. Another doc I met with (whose specialty was sleep) explained that the guideline he followed was to prescribe a half-dose of modafinil/provigil if the patient was on an MAOi. In that case, it meant prescribing 100mg provigil per day (as an adjunct to phenelzine/nardil, which was the MAOi I was on at the time), rather than 200mg, which he considered the standard starting dose. All this was in 2006.I think that, in general, MAOis are often put on the list of contraindications even when there is little evidence they're a danger, because, liability-wise, they're too dangerous. Also, the number of MAOi using patients is too small to offer much profit to companies producing drugs that might be used as adjuncts. I don't think it's inaccurate to say that, in this context, the PDR and other 'official' sources can be more legal documents, rather than medical ones.
Don't mean to discount the case reports mentioned earlier re safety issues in the parnate/provigil combination. I don't think parnate is ever -completely- safe, after all, even on its own. But I wanted to relay what seemed relevant information.
Best,
Psychbot
poster:psychobot5000
thread:761881
URL: http://www.dr-bob.org/babble/20070613/msgs/763137.html