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Re: Abilify + Other Meds » Elimino Pete

Posted by jedi on March 5, 2010, at 8:54:08

In reply to Re: Abilify » jedi, posted by Elimino Pete on March 4, 2010, at 20:44:52

Hi Pete,
As I remember, the bupropion did help with the delayed orgasm of Nardil. Of course they are contraindicated but I had no problem with high doses of both medications. My side effects from Nardil are really mild if I can keep the dosage down around 60mg. I have to add the 2mg of clonazepam in order to keep my social anxiety under control. Many people say that clonazepam worsens their depression, but I have not noticed that. It has a nice long half life so you don't get the ups and down of some of the shorter acting benzos.

I think medications, especially stimulants and others that affect dopamine can make a person abnormally aggressive. If you have ever had to deal with someone tweaking on methamphetamine, you will know what I mean.

I think most people can combine a low dose stimulant with Nardil under the right supervision. My MD is afraid to do it but he is not an expert on MAOIs. I think I have taught him most of what he knows about MAOIs. I am always sending him studies that I have read on them. I believe, if you are taking an MAOI like Nardil or Parnate, you really have to take your education and responsibility to the next level. There are so many doctors, pharmacists, and other health professionals with no knowledge of these medications.

I live in a small town in central Washington State. I don't think there are more than a couple of PDOCs in the whole town. And you have to be on Medicaid or welfare to even see them. Psychiatrists tend to congregate together in the large cities where there are more patients and more colleagues. This town is the medical center for all of Central Washington State. I just looked in the yellow pages. There are 223 MDs listed for the area. There is one psychiatrist listed.

Yes Nardil is one of the worse at causing delayed ejaculation. At the lower doses I am fine, at the upper doses, forget about orgasm. It does not seem to affect my libido, but I do use a compounded testosterone gel. Just getting old I guess.

The diet is no problem for me. The one thing I miss is the aged cheeses, but I can live with that. I don't eat anything that I don't know the ingredients, but the conservative MAOI diet is way overblown. I have never had trouble with any kind of alcohol, though I avoid tap bear just because you don't know how long since they cleaned the taps. Here is the diet I go by. This was written by a long term poster to this site, Elizabeth. This lady was a wealth of knowledge about treatment resistant depression. http://www.dr-bob.org/babble/20010814/msgs/75408.html Read some of her old posts on MAOIs and opioids if you get a chance; very interesting. I swear she had a photographic memory! Does anybody out there know what Elizabeth is doing now?

OTC medications are not a problem for me. I rarely get a cold anymore, and that stuff doesn't really help anyway. I do take diphenhydramine hydrochloride(Benadryl) for sleep. I also sometimes take a micro dose of Seroquel(12.5 mg) if the insomnia is bad. Again, do your own research on this. I was in British Columbia, Canada years ago; where they sell codeine over the counter. Codeine is fine, but they had mixed some pseudoephedrine or dextromethorfan in with the Codeine. The pharmacist swore it was fine with Nardil. I did not have my reading glasses and could not read the fine print on the bottle. Later, when I read it there was no MAOI warning at all. I guess the Canadians were used to seeing Moclobemide, the placebo of MAOIs. This mistake by the pharmacist cost me a trip to the ER with a BP that would not even register on my own cuff and a splitting headache. I trust no one but myself with Nardil interactions anymore.

That brings up another side effect for me. My presbyopia is worse on Nardil. I need reading glasses to read the paper. When not on Nardil I can read it just fine. Again, not a big deal; compared to major depression.

I have been on 45+ different combinations of antidepressants and augmenters. That is a lot of pain considering most of them were given at least four weeks before stopping each trial. Nardil with clonazepam has been the only thing that has worked for me. I am still looking for an augmenter to help with my residual dysthymia. A low dose stimulant would probably help, but I would have to go to Seattle and do a lot of research to find a PDOC who would prescribe it.

In my humble opinion, I believe that Nardil augmented with clonazepam is still the gold standard for atypical depression with social anxiety disorder. This combination can work when countless others have not. You do fight some side effects. For me the biggest battle is the carbohydrate cravings and associated weight gain. I keep this under control with intense exercise. But all of the side effects put together don't come close to serious major depression; where you are on the floor in a fetal position in such psychic torture you wonder how survival is possible.
Good Luck and Be Well,
Jedi

> Hello Jedi,
>
> Will definitely question the pdoc about the Abilify used without an antidepressant (that ought to piss him off). When it was working, it really seemed to work on the ADD too. Wellbutrin may be the one to request as it is the one that did not give me that lousy awful side effect of anorgasmia. It helped some with depression, but it was subtle. Maybe with Abilify augmenting it...?
>
> I'll watch out for that aggression symptom if I do try Wellbutrin next. I do tend to be a bit volatile, especially under stress. I don't often think in terms of meds being part of it, though clearly they may be. If it was a sure bet, I might get a good amount of bupropion in my veins and go out to take care of a couple of trouble makers that need to be cut down a notch or two now (just kidding- sort of). Wellbutrin or no Wellbutrin, you must be no small guy to be able to beat the s**t out of three troublemakers on the road! We're almost the same age and I don't even want to know how many pounds of muscle I've lost since in my prime.
>
> I don't really know what keeps me from going back to Nardil. It is partly that the stimulants do help me, but I took a small dose of Adderall with Emsam without issue. Emsam did not help me much at the lowest dose and I figured I'd go back to Nardil before upping Emsam and having to deal with the dietary restrictions anyway. I stopped short of doing just that. Maybe it is the dietary part, but I did handle that okay before. Probably it is the sexual side effects. I had to keep my Nardil dose quite low to be able to even tolerate them. Call me crazy (in a way that minimizes my extreme rejection sensitivity!), but I'd rather be depressed as to have major sexual dysfunction. Do you battle that too? How do you do with diet and contraindicated OTC and other drugs? I took the liberal road with it myself, but I was younger (am I obsessed with that?). I even drank without problems (did stay away from red wine which wasn't hard for me). I don't drink any more.
>
> If this Abilify 'tangent' doesn't come through and my pdoc doesn't know any other tricks we've not tried (too many to count), I may just go back to Nardil. My life has been so contained, more due to the social anxiety than anything else. I get used to it and even try to make friends with it, but its not truly any happy thing, as you must well know. Sometimes I think it is because I gave up alcohol, but most of the time, the smarter part of me realizes Alcohol was no true answer. It sure does treat social phobia effectively, but the side and after effects...oh God! Does your gut tell you I should go back to Nardil? I won't hold you responsible for anything so 'speak' freely please.
>
> I've got the CRS syndrome too and I'm sure there are multiple causes, including the many bad habits I supported in my youth (yes I guess I am traumatized by mid-life).
>
> Wish you well,
> Pete
>
>


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URL: http://www.dr-bob.org/babble/20100305/msgs/938610.html