Posted by steel on June 14, 2007, at 15:11:57
In reply to Re: Combining Provigil and Parnate, posted by psychobot5000 on June 14, 2007, at 13:30:06
>
> 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.
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> 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.
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> 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,
> PsychbotGood info,you mentioned half for nardil,nardil being more calming and using half then i wonder what parnate a "alleged" more activating one would require.I suppose half either way still including the usual benzo as needed with parnate.
poster:steel
thread:761881
URL: http://www.dr-bob.org/babble/20070613/msgs/763156.html