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Re: SLS » tensor

Posted by SLS on February 15, 2014, at 16:17:59

In reply to SLS, posted by tensor on February 15, 2014, at 2:13:57

> Hi Scott!

Hi Tensor!

> I have a couple of questions regarding Parnate augmentation, would be grateful if you could look at them. Others are welcome to chime in also.
>
> I can't find the post now, but I read that you had a severe reaction combining Parnate and reboxetine, what was the reaction?

Actually, my suicidal reaction to reboxetine occurred in the absence of a MAOI. I don't recall if I was taking any other drugs at the time.

> I'm trying to reduce daytime fatigue and I was thinking of adding a small dose of reboxetine in the morning.

I've been using Focalin (dexmethyphenidate) to use as a PRN for difficult days. One can add it to a MAOI safely.

> An alternative would be nortrip, but I don't know if I can add it when I'm at 50mg of Parnate already.

I don't see how nortriptyline would represent a greater risk than reboxetine when added to Parnate. Supposedly, one should add the MAOI to ongoing TCA treatment. I don't understand the rationale for this, though. I have not seen any evidence to support this notion. I have added TCA to ongoing MAOI treatment a number of times.

> A common friend of ours suggested agomelatine, what do you think about that?

I don't know what to make of agomelatine. I have seen it reduce rapid-cycling in bipolar 2 disorder. It had no therapeutic effect for me, but I was not taking a MAOI at the time. Perhaps the melatonin M1 an M2 receptor stimulation helps to regulate biological clocks. For depression, my guess is that the 5-HT2c antagonism participates in producing a treatment response.

> Thanks and I hope you have a nice weekend,

Thanks. I have had a difficult few days, both biologically and emotionally. Latuda made me feel significantly worse upon continued treatment and dosage increases, and I have run out of ideas for pharmacotherapy. Perhaps TMS is the next step. I am not feeling terribly optimistic.

> tensor

- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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