Posted by metamorphosis on December 31, 2012, at 10:12:47
In reply to Re: question for SLS » metamorphosis, posted by Phillipa on December 30, 2012, at 20:59:27
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Hi Christian> currently on 30 mg Parnate
30 mg is the minimum dose that is likely to be effective, many people need 50 mg and occasionally more. It at the monitor your sitting and standing blood pressure to gauge the effect of the drug, see attached PDF
> klonopin daily and the fact that Ambien also has a short half life. I think its the cross tolerance issue?
not really, but sort of I suppose. Drugs like Ambien are simply not used in the UK, indeed Halcion was essentially banned. Those very short acting drugs are of very limited use in people who are ill. Treating illness is what normalises the sleep pattern.
> So, I have noticed that people have and are using the TCAs-
> nortriptyline, amitriptyline, and doxepine.Is, all of those are safe with Parnate. Doxepin is really a sedative and has no significant antidepressant action and should probably not be classified as a TCA, rather as an antihistamine like from Phenergan. Nortriptyline it's probably better than AMI It to the because of its side-effect profile, see attached paper. It is not very sedative, but does improve sleep in some people.
> trazodone at 25-100mg for sleep. I though that combo would be dangerous. apparently the low 5HT effect of low dose trazadone makes it a careful but viable option?
despite everything that you read trazodone is actually an anti-serotonergic drug. It has significant five HT to be antagonistic properties which is probably why it helps sleep, and in that respect it is like doxepin but without the antihistamine effect. It seems to work well in conjunction with Parnate from what people and would probably be the first choice. It is definitely perfectly safe in combination with Parnate.> Also, some use zyprexa 25 mg for sleep. I am not a big fan of A.P./AAP�s, because of their potential side effects and also not needed for my diagnosis.
I would most definitely not be in favour of using antipsychotics as sleep aids. It is both unnecessary and carries completely unacceptable risks including that of NMS
> I would also like to start modafinil again. It works wonders for my alertness as a non-amp. stim. My pdoc is open to reintroducing it.
I would advise against reintroducing modafinil until the Parnate has shown its full effect been adjusted to optimal dosage. If at that point you think it might help it is certainly possible to combine it with Parnate.
Dr Ken Gillman
ken.psychotropical@gmail.com and kg@matilda.net.auWeb site for Serotonin toxicity research www.psychotropical.com
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poster:metamorphosis
thread:1034189
URL: http://www.dr-bob.org/babble/20121231/msgs/1034281.html