![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Peter on January 28, 2003, at 20:17:45
Hi everyone:
pdoc and I decided I hold off on taking the nortriptaline, so instead we titrated the lamictal from 50mg to 75mg @ a week ago. It does seem to have gotten me out of the awful depressed state I was in. But now my Social Phobia is really shining through. I get terrified at even the thought of going out to dinner or meeting new people, etc. Also, like with any other AC I've taken, I go through what I call 'wet blanket' periods-just feeling like there's a weight over me-sedate, spaced-out, losing track of words in the middle of sentences, foggy-headed, etc.. I'm also down to 30mg adderall, and I have no drive or excitement for anything. But my doc said the problem might be the 250mg depakote I'm still taking, so he's having me go off that, and he really thinks the lamictal will end up helping the social phobia! Wow, I never knew it could do that! Does anyone have experience w/lamictal helping SP?
If the lamictal isn't sufficient for my SP, he said that, if after stopping depakote I'm not too hyped up, we can either increase the adderall again (which he said is safer for me than starting back up on an ssri, even though I've experienced the most freedom from SP on ssri's-that is, before I start cycling). The other possibility, which we've been considering for a while, is an MAOI. He said they're the best-they would take care of my SP, depression, ADD, everything. But I'm just concerned about the food restrictions-what if you go to a restaurant and there's a little tyramine in some food-you gotta go to the hospital from a seratonergic attack? That's the only thing that really makes me wary about taking an MAOI. But he did mention some sort of antidote I can carry with me. So my second question is: What are people's experiences like with MAOI's, especially in terms of the tyramine thing?
I asked about the TCA route, but he said they do NOTHING for social anxiety. I don't know. I'd love any sort of feedback. Hope all is well with everyone-if not, I'm here to share and help out-so feel free to vent to me as I am to you (-: Thanks a lot,
Peter
Posted by SBOATRN on January 28, 2003, at 22:19:04
In reply to Well..No Nortriptaline, posted by Peter on January 28, 2003, at 20:17:45
My Mom took Parnate (MAOI) for 10 years for her Major Depressive Disorder and never experienced a "crisis". It worked well for her, too, when NOTHING else did. She did adhere to the dietary restrictions, but I can't imagine in 10 years she didn't ingest something by accident she shouldn't have. She was very careful... as you do have to be. Just to let you know some people are successful with this drug. Second hand knowledge but it is true !!
Posted by Lia Mason on January 28, 2003, at 22:24:31
In reply to Well..No Nortriptaline, posted by Peter on January 28, 2003, at 20:17:45
It's been years since I took MAOI's but I really had no trouble with the food list. It was very straightforward and a lot of the "forbidden" foods were sort of odd... pickled herring and such. No one ever told me to check ingredients. I stopped wine and cheese, I recall. Maybe beer, too. I stuck to a list; I never inquired about ingredients. My impression was that the wine in a sauce, for example, was not enough to hurt you. I had other problems with MAOI's--side effects. but the food list (for me) was no big deal.
Lia
Posted by Ritch on January 28, 2003, at 23:26:54
In reply to Well..No Nortriptaline, posted by Peter on January 28, 2003, at 20:17:45
> Hi everyone:
> pdoc and I decided I hold off on taking the nortriptaline, so instead we titrated the lamictal from 50mg to 75mg @ a week ago. It does seem to have gotten me out of the awful depressed state I was in. But now my Social Phobia is really shining through. I get terrified at even the thought of going out to dinner or meeting new people, etc. Also, like with any other AC I've taken, I go through what I call 'wet blanket' periods-just feeling like there's a weight over me-sedate, spaced-out, losing track of words in the middle of sentences, foggy-headed, etc.. I'm also down to 30mg adderall, and I have no drive or excitement for anything. But my doc said the problem might be the 250mg depakote I'm still taking, so he's having me go off that, and he really thinks the lamictal will end up helping the social phobia! Wow, I never knew it could do that! Does anyone have experience w/lamictal helping SP?
> If the lamictal isn't sufficient for my SP, he said that, if after stopping depakote I'm not too hyped up, we can either increase the adderall again (which he said is safer for me than starting back up on an ssri, even though I've experienced the most freedom from SP on ssri's-that is, before I start cycling). The other possibility, which we've been considering for a while, is an MAOI. He said they're the best-they would take care of my SP, depression, ADD, everything. But I'm just concerned about the food restrictions-what if you go to a restaurant and there's a little tyramine in some food-you gotta go to the hospital from a seratonergic attack? That's the only thing that really makes me wary about taking an MAOI. But he did mention some sort of antidote I can carry with me. So my second question is: What are people's experiences like with MAOI's, especially in terms of the tyramine thing?
> I asked about the TCA route, but he said they do NOTHING for social anxiety. I don't know. I'd love any sort of feedback. Hope all is well with everyone-if not, I'm here to share and help out-so feel free to vent to me as I am to you (-: Thanks a lot,
> Peter
Hi Peter, very interesting post. I have been having cognitive problems lately with Depakote and you said: "But my doc said the problem might be the 250mg depakote I'm still taking". I reduced my Depakote back down from 250mg to 125mg and I feel much better. I was watching the Super Bowl and had no usual enthusiasm about the game at all (until the 4th quarter though). More importantly, a couple of days ago I started to develop transient slurred speech problems. I think I am getting a neurotoxic response to the Depakote. I want to go back on some Neurontin instead. It is true about TCA's and SP, you would have to combine it with an MAOI or SSRI to get an effect there.
Posted by kara lynne on January 28, 2003, at 23:29:36
In reply to Re: Well..No Nortriptaline, posted by Lia Mason on January 28, 2003, at 22:24:31
I'm glad to hear the food restrictions weren't a problem for you, but I'd like to find out what made you stop taking Nardil...? Thank you.
Posted by Luka62 on January 29, 2003, at 0:03:47
In reply to Well..No Nortriptaline, posted by Peter on January 28, 2003, at 20:17:45
> Hi everyone:
> pdoc and I decided I hold off on taking the nortriptaline, so instead we titrated the lamictal from 50mg to 75mg @ a week ago. It does seem to have gotten me out of the awful depressed state I was in. But now my Social Phobia is really shining through. I get terrified at even the thought of going out to dinner or meeting new people, etc. Also, like with any other AC I've taken, I go through what I call 'wet blanket' periods-just feeling like there's a weight over me-sedate, spaced-out, losing track of words in the middle of sentences, foggy-headed, etc.. I'm also down to 30mg adderall, and I have no drive or excitement for anything. But my doc said the problem might be the 250mg depakote I'm still taking, so he's having me go off that, and he really thinks the lamictal will end up helping the social phobia! Wow, I never knew it could do that! Does anyone have experience w/lamictal helping SP?
> If the lamictal isn't sufficient for my SP, he said that, if after stopping depakote I'm not too hyped up, we can either increase the adderall again (which he said is safer for me than starting back up on an ssri, even though I've experienced the most freedom from SP on ssri's-that is, before I start cycling). The other possibility, which we've been considering for a while, is an MAOI. He said they're the best-they would take care of my SP, depression, ADD, everything. But I'm just concerned about the food restrictions-what if you go to a restaurant and there's a little tyramine in some food-you gotta go to the hospital from a seratonergic attack? That's the only thing that really makes me wary about taking an MAOI. But he did mention some sort of antidote I can carry with me. So my second question is: What are people's experiences like with MAOI's, especially in terms of the tyramine thing?
> I asked about the TCA route, but he said they do NOTHING for social anxiety. I don't know. I'd love any sort of feedback. Hope all is well with everyone-if not, I'm here to share and help out-so feel free to vent to me as I am to you (-: Thanks a lot,
> Peter
Hi Peter, I was put on Lamictal 1 1/2 yrs ago. I was on on 50mg 2x/day until 1 weeks ago, pdoc is titrating it up, so I'm taking 50mg in the am and 100mg at night, plus I'm on Nardil 30mg/day.(The Nardil dosage changed over the years anywhere from 3o-75mg, up and down.)
Both meds are good in keeping my moods more stable. My social phobia is still difficult to deal with. I'm even considering asking the doc to put me back on valium for a while the anxiety is so bad.
As far as the dietary restrictions, knowing what foods are highest in Tyramine and which ones are moderately high and low content helps a lot. Im searching for updated info.
Oh, I was wondering, what kind of antedote did the doc say you could carry with you? Was it a shot of epinephrine? I hadn't heard of that. Some food items are quite high in tyramine -just about anything aged is on the hitlist. If you get sick it can be tough because OTC meds that contain pseudoephedrine, dextromethorphan or phenylpropanoline are no-nos.
On Nardil for 16yrs now, have had true emergencies 2 times; one I was inpatient and the resident physician ordered Demerol and I went into arrest; and the other time I'm not sure if it was an independant allergic reaction to a new med I was given..(voltaren, a non-steroidal) or if interaction with the nardil or combo of both. Its likely the Nardil because I'd taken the pill, and 15 minutes later my blood pressure shot up sky high I my breathing was affected, and had to be given benadryl, epinephrine 2x, and iv's in th er. Nardil has always kept my blood pressure lower than normal, sometimes Very low> An interaction can cause severe headache, a rapid rise in blood pressure, chest pain, breathing difficulty. It's a serious medication to go on, but it has been quite beneficial for me.
Good Luck to you.
Posted by Lia Mason on January 29, 2003, at 0:47:40
In reply to Lia, what were your s/e's with Nardil?, posted by kara lynne on January 28, 2003, at 23:29:36
Hi. I gained weight on Nardil, but it was like bloating. My feet swelled, actually. My shoes got tight. Very strange. I had a lot of blood pressure stuff--nothing dangerous, but I'm low to begin with and the Nardil made my pressure drop so that on occasion my vision would get dark. It sounds worse than it was. It was infrequent, but disconcerting. Honestly, the total sexual dysfunction was hardest for me. But I get it on everything. Some drugs it's more pronounced than others. I've found the MAOI's to be the worse offenders. Too bad, because they were (for me) great antidepressants.
Best,
Lia
Posted by Lawrence S. on January 29, 2003, at 1:55:05
In reply to Well..No Nortriptaline, posted by Peter on January 28, 2003, at 20:17:45
Peter, Lamictal worked incredibly well for my social phobia, but after a while I became deppresed. I did however take it along with ritalin, wellbutrin and lexapro. It seems like it gives you a boost for a few weeks and then you need to increase the dose. Or in my case, leave the dose the same and then deppresion sets in. Maybe it would have worked better if I had been on a more potent AD to counteract this. But then it also seemed to cause mood fluctuation so I gave it up.
When I was on nardil I occaisionally ate tyramine unknowingly and nothing happened. It was a constant fear for me. I would order salads in a restaurant and find cheese in it when I specifically asked for no cheese. I found that Hershey's chocolate bars were OK, but then I had just a little bit of Brachs chocolate stars and found that my neck was starting to get stiff and checked my B.P. and it was elevated. luckilly, it soon passed without complications. You have to be carefull.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.