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Re: Making PEA 'active' with MAOIs tecknohed

Posted by Ron Hill on February 18, 2008, at 2:19:00

In reply to Making PEA 'active' with MAOIs, posted by tecknohed on January 21, 2008, at 21:42:58

> what about the older MAOIs Nardil, Parnate & Marplan?

> would these particular MAOIs make it dangerous?

> I've read many anecdotal reports where people have had amazing experiences combining PEA with selegiline, with some even reporting that the high is better than crack but with little or no comedown!

> Your thought/experiences?

> teck
--------------------------

Teck,

This post got kinda long on me. Sorry.

Please refresh my memory, Teck; are you currently taking an MAOI? If so, which one and what dosage?

A few months ago, I conducted a brief trial in which I added a small dose of PEA to my meds. At the time, my meds included 90 mg/day of Nardil.

Here is a list of all the meds and dosages I was taking at the time:

600 mg/day Trileptal
200 mg/day Lamictal
875 mg/day Keppra
90 mg/day Nardil

My purpose for conducting the trial was to determine if the add-on PEA with Nardil would tx my bipolar depressive phase. It did not take long for me to get an answer. PEA worked great as an antidepressant; in fact it was incredible. Within minutes after taking it my depression was completely gone.

Generally speaking, research shows that depressed pts tend to have low CSF levels and low plasma levels of endogenous PEA. Further, a manic pt typically has elevated levels of PEA. Neither extreme is beneficial. Too low and the pt is at risk of depression; too high, and the pt may become agitated and overly aggressive. I bring this information up solely to lay the groundwork needed to explain the rationale behind the PEA dosing schedule that I used during my trial.

I am a bipolar II ultra-rapid cycler. I cycle once every 15 days, and my cycling period is very consistent. I can set my watch by it. I set up the trial, so as to administer PEA during my depressive phases, but not during my normal and hypomanic mood phases.

My rationale for this dosing schedule was that I needed to take exogenous PEA during my depressive phases in order to offset the deficit of endogenous PEA. On the other hand, when I cycled out of depression and into a normal mood phase or hypomanic mood phase, exogenous PEA would not be beneficial. In fact, it could induce a dysphoric mood state. Therefore, I discontinued use of exogenous PEA during my normal and hypomanic mood phases.

However, as it turned out, my PEA dosing schedule failed miserably. When I would stop taking PEA during my normal or hypomanic mood states, the rebound depression was ABSOLUTELY horrendous. The conclusion I came to was that, if I were to try PEA as an add-on to Nardil again sometime in the future, I would need to take PEA all the time, regardless of my mood state.

^ Too Much Information. ^

Ever since I aborted my original PEA trial, a part of me has really wanted to conduct a new redesigned trial of PEA added-on to Nardil. The way PEA instantly took away my depression and left me feeling calm and peaceful was remarkable.

However, my gut feeling is that PEA will work great for a while, and then it will make me VERY IRRITABLE GRRRRRRRR. And, then Id have to go through the horrendous PEA withdrawal.

Teck, as you know, by far the most common MAOI to use with PEA is selegiline (Deprenyl). Typically, the selegiline dosage used is no more than 10 mg/day so that it is a selective MAOI-B. In the study linked below, Sabelli et al used 10 mg of selegiline and PEA dosages of 10 60 mg/day depending on the amount needed by any given pt.

Obviously, the selective MAOI-B eliminates the risk of a hypertensive crisis. Therefore, high PEA dosages (60 mg/day) can be safely used. However, this is not the case for Nardil. In the documents linked below, passing reference is made to the use of Nardil with PEA, but no dosage range guidance is provided.

During my trial of PEA with Nardil, I used a very cautious trial-and-error procedure to find a PEA dosage that felt right. I kept my blood pressure machine and my nifedipine close at hand. I monitored my blood pressure frequently in the beginning of the trial.

The PEA that I purchased is a bottle containing 120 capsules with each capsule containing 250 mg of PEA in a granular form. Clearly, if I would have taken a 250 mg capsule of PEA with 90 mg/day of Nardil on-board, well you can fill in the blanks.

Instead, I opened a capsule and emptied the contents onto a plate. The dosage that ended up working well for me was measured and administered as follows: I wetted the very tip of my pinky finger and touched my wetted finger tip lightly onto the granular PEA on the plate. I would then lick the PEA off of my pinky finger tip. My best rough estimate is that I was likely taking about 10 mg/day of PEA, but I really dont have an accurate value.

^ Okay, enough rambling.^

The full texts of the following two documents are worth reading by any and all interested in PEA administered with an MAOI. However, let me start out by providing links to the two corresponding abstracts. As you will see below, there are a few steps required to pull up the full documents, and some people reading this post might prefer to just read the abstracts:

Sustained antidepressant effect of PEA replacement
http://neuro.psychiatryonline.org/cgi/content/abstract/8/2/168

Phenylethylamine modulation of affect: therapeutic and diagnostic implications
http://neuro.psychiatryonline.org/cgi/content/abstract/7/1/6

Okay, now lets pull up the full text pdf documents. Its not straight forward because the Journal of Neuropsychiatry and Clinical Neurosciences does not offer free access to their full text versions. Therefore, I hunted around and found a back door that allows us free access to the full text versions of the two articles of interest.

Here are the directions for accessing the two full text documents via the back door. Its easy:

1. Click here: http://bjsm.bmj.com/cgi/content/full/35/5/342

2. Go to the bottom of the page that you just pulled up, and click on Register for Access. Registration is free on the BJSM site.

3. Fill out the registration information.
SIDE NOTE: After registering, you might be automatically and immediately routed to the full text version of the article titled "Phenylethylamine, a possible link to the antidepressant effects of exercise?". If so, skip steps 4 and 5.

4. Click on the link in Step 1 above.

5. Fill in your user name and password that you just got when you registered. The full text of the article, "Phenylethylamine, a possible link to the antidepressant effects of exercise?", will come up on your screen.

6. Scroll down until you get to the References section at the bottom of the full text document entitled, "Phenylethylamine, a possible link to the antidepressant effects of exercise?". Now we have arrived at the back door. The two articles we want are Reference 2 and Reference 3.

7. Click on the Free Full Text link for Reference 2; { Sabelli H, Fink P, Fawcett J, et al. Sustained antidepressant effects of PEA replacement. J Neuropsychiatry 1996;8:16871}

8. Access to the abstract of the article we want will come up. In the menu box on the right hand side of the page, (directly adjacent to the abstract text), click the first entry; Full Text (PDF).

9. Click [Begin manual download].

10. Read the full text pdf of Sustained antidepressant effects of PEA replacement.

11. Return to the References listed at the bottom of the document entitled, "Phenylethylamine, a possible link to the antidepressant effects of exercise?", and click on the Free Full Text link for Reference 3; { Sabelli H, Javaid J. Phenylethlyamine modulation of affect: therapeutic and diagnostic implications. J Neuropsychiatry Clin Neurosci 1995;7:614.}

12. Read the full text pdf of Phenylethlyamine modulation of affect: therapeutic and diagnostic implications.

13. If you have time, you may find it worthwhile to also read "Phenylethylamine, a possible link to the antidepressant effects of exercise?"


Here is a short Letter to the Editor on the PEA topic. The document of interest starts in the center column. Pay special attention to the fact that the author mentions the use of PEA with Nardil. Just click the link provided:

http://neuro.psychiatryonline.org/cgi/reprint/6/2/203

Remember Teck

Rule #1: Nobody gets hurt!

Rule #2: Don't forget Rule #1!!

I care about you, Bud. Be smart, do your p-homework before you monkey with PEA, and don't do anything stupid.

-- Ron

Bipolar II with ultra rapid cycling (15 day cycle), and mild Obsessive Compulsive Personality Disorder (OCPD)

300 mg/day Trileptal (My antimanic med left idling in the background. If I get hypomanic, I jump it up to 600 or 900 until my hypomania subsides.)

200 mg/day Lamictal

250 mg/day Keppra

75 mg/day Nardil

50 mg/day Topamax

7.5 mg/day Deplin (but I skip days periodically)



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poster:Ron Hill thread:808257
URL: http://www.dr-bob.org/babble/neuro/20080204/msgs/813379.html