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Re: Desoxyn with MAOIs --) SLS » tom2228

Posted by SLS on May 23, 2014, at 10:28:05

In reply to Desoxyn with MAOIs --) SLS, posted by tom2228 on May 23, 2014, at 8:52:34

> Hey Scott,
>
> I saw a new (amazing) doc yesterday who said he contacted STAHL (!!) about my case -- who said that Desoxyn + an MAOI + TCA is safe.
>
> I am taking still taking 22.5mg Desoxyn + 40mg Marplan + now 25mg desipramine (titrating, switched from nortriptyline), + all the rest.
>
> Hope you're well,
> Tom


OMG! Desoxyn? Isn't that a potent serotonin releaser? Perhaps a selective releaser, and not a reuptake inhibitor, allows for the combination without precipitating serotonin syndrome. I am glad that your doctor is now unafraid to add desipramine. It can be a squirrely drug at first. It will feel harsh compared to nortriptyline. You might experience a feeling of being "wired" or uncomfortably energetic. You will notice your accelerated heart rate. You might experience palpitations. Even though desipramine is devoid of anticholinergic activity, the effects of a hyperadrenergic state will mimic the more familiar anticholinergia. These things may lessen over time, but not disappear entirely. Still, the side effects are relatively minor compared to the powerful antidepressant properties desipramine can exert.

I'm doing okay. I am in the midst of discontinuing nortriptyline. I have already discontinued Abilify (amotivation / laziness) and minocycline (hyperpigmentation of the feet, ankles, and shins). I experienced withdrawal phenomena for discontinuing both drugs. Discontinuing Abilify produced an brief acute depression immediately and a more extended, albeit less severe, depression a few weeks later. Discontinuing minocycline produced a profound fatigue that felt much like an amphetamine let-down. This lasted for about a week.

My doctor suggested that I may no longer need the nortriptyline since adding prazosin. It would be nice to lose weight and resolve the xerostomia that adds to tooth decay and gum disease..

Currently:

Parnate 100 mg/day
nortriptyline 100 mg/day (tapering from 150 mg/day for discontinuation)
Lamictal 200 mg/day
lithium 450 mg/day
prazosin 30 mg/day


I told my doctor that the best we have been able to do so far is to provide me with palliative treatment to reduce the severity of symptoms without producing a truly robust antidepressant response. This is inadequate. However, I am afraid of DBS, which is a treatment he feels I should investigate. There do not seem to be any convenient answers. Deep TMS? Maybe. Brintellix? I am not convinced that it has worked magic for anyone on Psycho-Babble yet. I am waiting for my doctor to develop a better feel for Brintellix in order for me to decide if it is worth discontinuing Parnate for.

Good luck with your desipramine trial!


- 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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