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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by timidly on December 9, 2003, at 22:22:43
Does anyone know if it is safe to take Abilify while taking Nardil (an MAOI)? My pdoc gave me a months supply of Abilify samples and wants me to start taking Abilify tomorrow morning. I am currently taking 120 mg Nardil (an MAOI), 80 mg Metadate ER (time released Ritalin), 10 ug Cytomel, and 100 mg Trazodone for recalcitrant (treatment resistant) major depression.
Thanks,
Posted by gardenergirl on December 9, 2003, at 22:37:39
In reply to Combination of MAOI and Abilify, posted by timidly on December 9, 2003, at 22:22:43
I just ran your list of meds on a program I have for my Palm called Epocrates. It did not show any interactions between Abilify and Nardil; however, there were a few interactions on your other meds you may already be aware of:
Nardil and trazodone: contraindicated; combo may increase risk of serotonin syndrome (additive/synergistic effects)
Abilify and trazodone: caution advised. Combo may increase risk of CNS depression; psychomotor impairment
Metatdate ER and Nardil: Contraindicated: combo may result in hypertensive crisis (synergistic effects).
Don't mean to alarm you, but when on multiple meds, there is a lot to consider. The program on my palm gets updated from the web daily. It could have mistakes, but better safe than sorry. Is your pdoc experienced in combining meds? You seem to be on a high dose of Nardil. I'm worried that you are at much more risk for nasty side effects.
Recalcitrant depression can be a real challenge. I hope you find a safe, and more importantly, effective combination that works for you!
Posted by Steeler Tookahn on December 10, 2003, at 17:42:58
In reply to Combination of MAOI and Abilify, posted by timidly on December 9, 2003, at 22:22:43
I have been taking a large dose of Parnate (an MAOI) and 20 mg of Abilify with no problems -at least so far.
Posted by timidly on December 10, 2003, at 19:35:49
In reply to Re: Combination of MAOI and Abilify, posted by gardenergirl on December 9, 2003, at 22:37:39
> I just ran your list of meds on a program I have for my Palm called Epocrates. It did not show any interactions between Abilify and Nardil; however, there were a few interactions on your other meds you may already be aware of:
> Nardil and trazodone: contraindicated; combo may increase risk of serotonin syndrome (additive/synergistic effects)
> Abilify and trazodone: caution advised. Combo may increase risk of CNS depression; psychomotor impairment
> Metatdate ER and Nardil: Contraindicated: combo may result in hypertensive crisis (synergistic effects).
> Don't mean to alarm you, but when on multiple meds, there is a lot to consider. The program on my palm gets updated from the web daily. It could have mistakes, but better safe than sorry. Is your pdoc experienced in combining meds? You seem to be on a high dose of Nardil. I'm worried that you are at much more risk for nasty side effects.
> Recalcitrant depression can be a real challenge. I hope you find a safe, and more importantly, effective combination that works for you!Thank you very much for the information. I am very aware of the Nardil/Ritalin contraindication, as is my pdoc (and as were all my previous pdocs). Prior to starting the Nardil I had labile hypertension. My BP became rock solid at 120/80 after starting the Nardil. I still remember vividly when Dr. Hugh MacNamee at Dartmouth-Hitchcock Medical Center first started me on the combination 25 years ago. After signing informed consent, I spent the better part of a day in a room with my vital signs continously monitored when I took the first dose of 1.25 mg, then 2 hours later another 2.5 mg, then another 2 hours later another 5 mg. My Blood Pressure remained rock solid. My BP was monitored twice daily for a week, then daily for 3 months. I have now been on the combination of Nardil and Ritalin for 25 years and my BP is still rock solid.
I was not aware of the contraindication between Nardil and Trazodone, and I will definitely check into that.
My pdoc got the okay from my pharmacist before giving me the Abilify samples yesterday afternoon. Last night I got a call from my pharmacist telling me not to take any Abilify yet, stating they had found some contraindications for medications with somewhat similar effects in the brain, and that they were waiting for a response from pharmaceutical company. My pdoc called me a few minutes ago and told me that there was no safety information about the combination of Abilify and MAOIs, and that he was not willing to take the risk. He told me not to take any Abilify, that he would try Lamictel instead.
Posted by gardenergirl on December 10, 2003, at 21:50:23
In reply to Re: Combination of MAOI and Abilify » gardenergirl, posted by timidly on December 10, 2003, at 19:35:49
Sounds like you have an excellent pdoc!
Posted by cybercafe on December 11, 2003, at 19:12:42
In reply to Re: Combination of MAOI and Abilify, posted by Steeler Tookahn on December 10, 2003, at 17:42:58
> I have been taking a large dose of Parnate (an MAOI) and 20 mg of Abilify with no problems -at least so far.
strange thing, did you find that abilify gives you insomnia and parnate gives you insomnia, but when you combine them you don't get insomnia?
same thing with libido, great on abilify, great on parnate, normal on the combination of the two
btw i'm taking abilify 4 mg + parnate 40 + ritalin SR 40 tid + clonazepam 2 mg bid
Posted by Steeler Tookahn on December 12, 2003, at 12:31:31
In reply to Re: Combination of MAOI and Abilify, posted by cybercafe on December 11, 2003, at 19:12:42
> > I have been taking a large dose of Parnate (an MAOI) and 20 mg of Abilify with no problems -at least so far.
>
> strange thing, did you find that abilify gives you insomnia and parnate gives you insomnia, but when you combine them you don't get insomnia?
>
> same thing with libido, great on abilify, great on parnate, normal on the combination of the two
>
> btw i'm taking abilify 4 mg + parnate 40 + ritalin SR 40 tid + clonazepam 2 mg bid
That is EXACTLY what I have have found. I thought I was the only one finding these contra-indications when taking the 2 medicines tohether.
Posted by cybercafe on December 13, 2003, at 5:13:39
In reply to Re: Combination of MAOI and Abilify, posted by Steeler Tookahn on December 12, 2003, at 12:31:31
> > > I have been taking a large dose of Parnate (an MAOI) and 20 mg of Abilify with no problems -at least so far.
> >
> > strange thing, did you find that abilify gives you insomnia and parnate gives you insomnia, but when you combine them you don't get insomnia?
> >
> > same thing with libido, great on abilify, great on parnate, normal on the combination of the two
> >
> > btw i'm taking abilify 4 mg + parnate 40 + ritalin SR 40 tid + clonazepam 2 mg bid
>
>
> That is EXACTLY what I have have found. I thought I was the only one finding these contra-indications when taking the 2 medicines tohether.
>how long have you been on them for?
Posted by Steeler Tookahn on December 13, 2003, at 12:49:18
In reply to Re: Combination of MAOI and Abilify, posted by cybercafe on December 13, 2003, at 5:13:39
> > > > I have been taking a large dose of Parnate (an MAOI) and 20 mg of Abilify with no problems -at least so far.
> > >
> > > strange thing, did you find that abilify gives you insomnia and parnate gives you insomnia, but when you combine them you don't get insomnia?
> > >
> > > same thing with libido, great on abilify, great on parnate, normal on the combination of the two
> > >
> > > btw i'm taking abilify 4 mg + parnate 40 + ritalin SR 40 tid + clonazepam 2 mg bid
> >
> >
> > That is EXACTLY what I have have found. I thought I was the only one finding these contra-indications when taking the 2 medicines tohether.
> >
>
> how long have you been on them for?
>I've been on 100 mg Parnate for about 4 years and 20mg Abilify for about 4 months. We're slowly reducing the Abilify because i think I am on a much higher dose than I need.
I've also been on Lamictal for about 2 years and thyroid medication.
Posted by brussell on December 14, 2003, at 14:52:44
In reply to Re: Combination of MAOI and Abilify, posted by Steeler Tookahn on December 13, 2003, at 12:49:18
> I've been on 100 mg Parnate for about 4 years and 20mg Abilify for about 4 months. We're slowly reducing the Abilify because i think I am on a much higher dose than I need.
> I've also been on Lamictal for about 2 years and thyroid medication.Wow, that's an awful lot of Parnate. Did it really not work for you until you went to such a high dose? Do you get blood pressure problems on that dosage?
Posted by Steeler Tookahn on December 14, 2003, at 15:05:38
In reply to Re: Combination of MAOI and Abilify, posted by brussell on December 14, 2003, at 14:52:44
>
> > I've been on 100 mg Parnate for about 4 years and 20mg Abilify for about 4 months. We're slowly reducing the Abilify because i think I am on a much higher dose than I need.
> > I've also been on Lamictal for about 2 years and thyroid medication.
>
>
>
> Wow, that's an awful lot of Parnate. Did it really not work for you until you went to such a high dose? Do you get blood pressure problems on that dosage?
>It IS a very high dose but my depression kept breaking through. i had this experience many years back when i took Parnate for about 10 years. It worked beautifully but needed a higher dose about once or twice a year to keep working. Over 100 mgs and I don't get any more benefit from it and most doctors don't want to go over 100mgs (understandably). If it stops working it will start working again if I go off it for about a year.
It has slightly lowered my blood pressure (which is a good thing) and I've never had a hypertensive crisis no matter what I eat. The only things I'm afraid of are blue cheese and the medication (over the counter and prescribed) that should never be taken with it.
This is the end of the thread.
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