Psycho-Babble Medication Thread 46422

Shown: posts 1 to 11 of 11. This is the beginning of the thread.

 

any experience/knowledge of augmenting MAOI's??

Posted by JohnM on October 15, 2000, at 14:55:39

I presently take Nardil. It worked well for me years ago, but not so much lately. Any input would be appreciated. John

 

Re: any experience/knowledge of augmenting MAOI's?? » JohnM

Posted by shellie on October 15, 2000, at 15:45:18

In reply to any experience/knowledge of augmenting MAOI's??, posted by JohnM on October 15, 2000, at 14:55:39

> I presently take Nardil. It worked well for me years ago, but not so much lately. Any input would be appreciated. John


John, I wrote the following post a couple of months ago to someone else who answered the same question, so I thought I'd copy it here for you:

>I'm going to give you all the information that I gathered since January, when I felt the nardil lost effectiveness, since some part of it may be helpful to you. I'll try to condense.

In Feb did a trial of sam-e with Nardil, with on the phone supervision with a physician affiliated with Columbia U. who wrote a book on sam-e. He gave sam-e a 70% change of working. Unfortunately, it was not good for me--it made me more depressed and very agitated. But if you look at the sam-e board at www.delphi.com a lot of people who had tried lots of prescription meds, had enormous success with it.

He also said if the sam-e didn't work, these would be his recommendations to try with nardil:

1. thyroid, add 25 mc of cytomel (t3) for 2 weeks; can try 37.5 also
***2. lamcital- (anti-seizure medication) have to go up very very slowly„over a 3 month period--
3. add very low lithium level (works 50% of time)„
4. add traxedone (deserel)
5. add pindolol
6. add ridlin or dexadrine or adderall

Because my pdoc was unwilling to experiment, I also consulted with a pdoc at NIMH by phone (very helpful) and with my old pdoc, who was no longer
accepting my insurance.

The first choice of all three was lamictal. In the last" MAOI doesn't work anymore" thread, I explained that lamictal worked for me really well, but I was gaining weight. A very small percent of people gain weight on lamictal. I was unlucky and unwilling to accept a weight gain since there were other things for me to try. But I think it is very significant that all three doctors I consulted with, picked that as their first choice. >

Anyway, since that post I've tried the following augmentors with nardil (all unsuccessfully)
aricept
naltrezone
provigal
topmax
stimulents: ritalin, dexadrine
resperadone speech slurred)
amisulpride french anti-psychotic
adrafinil (french stimulent-had seratone reaction with combination--I don't recommend).

After getting off of nardil and trying serzone, I am now back on nardil and am adding some serzone. If I were you, my first choice would be lamictal, since it was recommended for me to try independently by three different doctors and it worked. (And very few people gain weight on it). Or deseral.

Good luck, hope I didn't overwhelm you. Shellie


 

Re: augmenting Parnate? » JohnM

Posted by Tori on October 15, 2000, at 19:28:55

In reply to any experience/knowledge of augmenting MAOI's??, posted by JohnM on October 15, 2000, at 14:55:39

Sorry to add to this thread, but I wanted to ask this question as well.

Currently on Parnate 10 mg bid and Lamictal 150 mg bid, plus 2-6 mg clonazepam and 30 - 90 mg restoril at night prn.

I am still tired and lethargic on the Parnate and have gained weight (remarkable). What can I augment with the Parnate that will give me energy and enable me to exercise again?

Any suggestions would be greatly appreciated.

Thank you so much, Tori :-)

 

Re: augmenting Parnate?

Posted by JohnM on October 15, 2000, at 19:49:03

In reply to Re: augmenting Parnate? » JohnM, posted by Tori on October 15, 2000, at 19:28:55

I'm not an expert on augmenting MAOI's (but see Shellie's post), but as far as the clonazepam, I take it and found it to be quite sedating. I started spliting my 0.5 tablets into quarters or even eighths and I still get a satisfactory anti-anxiety effect without the sedation. You might investigate the lethargy from that angle and reduce your clonazepam dose. John :)

 

Thanks a million Shellie!

Posted by JohnM on October 15, 2000, at 19:52:50

In reply to Re: any experience/knowledge of augmenting MAOI's?? » JohnM, posted by shellie on October 15, 2000, at 15:45:18

I am so grateful for your response, Shellie. It seems it is hard to get information when it comes to MAOI's. I will take your suggestions. Thank you very, very much. John

 

Re: Thanks a million Shellie! » JohnM

Posted by SLS on October 15, 2000, at 21:57:15

In reply to Thanks a million Shellie!, posted by JohnM on October 15, 2000, at 19:52:50

> I am so grateful for your response, Shellie. It seems it is hard to get information when it comes to MAOI's. I will take your suggestions. Thank you very, very much. John

Also,

1. Wellbutrin

2. Zyprexa 2.5 - 5.0mg (I'm real interested in a Nardil + Zyprexa combination)

3. Tricyclic: desipramine or nortriptyline


- Scott

 

Re: any experience/knowledge of augmenting MAOI's?? » shellie

Posted by SLS on October 15, 2000, at 22:08:39

In reply to Re: any experience/knowledge of augmenting MAOI's?? » JohnM, posted by shellie on October 15, 2000, at 15:45:18

Dear Shellie,

I've been thinking about adding Serzone to an MAOI for the last few months, but I wasn't sure how safe the combination would be. I figured it might not be any riskier than adding trazodone. I was planning on bringing it up at my next doctor's appointment.

Out of curiousity, what made you choose Serzone?

It is a logical choice. I wish you well.

If it works, you better let me know!!!

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

etc.

(((((shellie)))))

- Scott


> After getting off of nardil and trying serzone, I am now back on nardil and am adding some serzone. If I were you, my first choice would be lamictal, since it was recommended for me to try independently by three different doctors and it worked. (And very few people gain weight on it). Or deseral.

 

Re: any experience/knowledge of augmenting MAOI's?? » SLS

Posted by shellie on October 15, 2000, at 23:21:34

In reply to Re: any experience/knowledge of augmenting MAOI's?? » shellie, posted by SLS on October 15, 2000, at 22:08:39

> Dear Shellie,
>

>
> Out of curiousity, what made you choose Serzone?
>
> It is a logical choice. I wish you well.
>
> If it works, you better let me know!!!
>
> !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Hi Scott. I'm so happy to hear from you. How are you?

I went back to my last pdoc--the new guy was scheduling two (TWO!) patients every fifteen minutes and instead of working out an overall plan, would just say, "okay, up the serzone, make an appointment for the end of the week." So, I was sinking, fighting (because of work) not to go into the hospital, and felt he didn't even know who the hell I was by the end of the week.

Despite what I felt were some poor decisions on her part (to encourage me to keep taking topomax after two weeks of sleeping all day and no depression relief, and the last straw--giving me serequel as a stand alone med which I took for one day and changed pdocs), I know my pdoc knows her stuff and knows me, and really cares about me. She did have an explanation about the serequel (she thought my thought processes were difficult to understand), but christ, I was DEPRESSED and exhausted.

So I send her a two page fax, saying that I wanted my strategy to be well planned out (benefit/risk ratios, etc.) and I wanted to go back on either nardil or start parnate. We looked over all my combinations over the years and I had success on serzone and nardil before (her idea, about five years ago). But it ended up not working out, because I had such a large drop in BP and despite our best efforts, couldn't counter it, without really bad side effects.

So why try again? (you might ask). I was so desperate, I didn't want to try anything new. Even if it just got me through my Christmas rush, it seemed like a good place to start again. since it worked really well on the depression. I have very low blood pressure and am not a big salt fan, so we decided I had the latitude to indulge in salt pills, and see how that worked. I have not added serzone yet, but the last two days my depression has lifted ; I don't even know why, and assume it's temporary. But what a relief! I actually went to the movies last night and mowed my lawn today.

So, that's my saga. Has your new pdoc come up with any ideas that you haven't come up with yourself? Anyway, what do you think about your new guy and really, how are you doing? I've missed you. Shellie

 

Re: any experience/knowledge of augmenting MAOI's??

Posted by stephanie l. on October 17, 2000, at 18:24:21

In reply to Re: any experience/knowledge of augmenting MAOI's?? » SLS, posted by shellie on October 15, 2000, at 23:21:34

> > Dear Shellie,
> >
>
> >
> > Out of curiousity, what made you choose Serzone?
> >
> > It is a logical choice. I wish you well.
> >
> > If it works, you better let me know!!!
> >
> > !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
>
> Hi Scott. I'm so happy to hear from you. How are you?
>
> I went back to my last pdoc--the new guy was scheduling two (TWO!) patients every fifteen minutes and instead of working out an overall plan, would just say, "okay, up the serzone, make an appointment for the end of the week." So, I was sinking, fighting (because of work) not to go into the hospital, and felt he didn't even know who the hell I was by the end of the week.
>
> Despite what I felt were some poor decisions on her part (to encourage me to keep taking topomax after two weeks of sleeping all day and no depression relief, and the last straw--giving me serequel as a stand alone med which I took for one day and changed pdocs), I know my pdoc knows her stuff and knows me, and really cares about me. She did have an explanation about the serequel (she thought my thought processes were difficult to understand), but christ, I was DEPRESSED and exhausted.
>
> So I send her a two page fax, saying that I wanted my strategy to be well planned out (benefit/risk ratios, etc.) and I wanted to go back on either nardil or start parnate. We looked over all my combinations over the years and I had success on serzone and nardil before (her idea, about five years ago). But it ended up not working out, because I had such a large drop in BP and despite our best efforts, couldn't counter it, without really bad side effects.
>
> So why try again? (you might ask). I was so desperate, I didn't want to try anything new. Even if it just got me through my Christmas rush, it seemed like a good place to start again. since it worked really well on the depression. I have very low blood pressure and am not a big salt fan, so we decided I had the latitude to indulge in salt pills, and see how that worked. I have not added serzone yet, but the last two days my depression has lifted ; I don't even know why, and assume it's temporary. But what a relief! I actually went to the movies last night and mowed my lawn today.
>
> So, that's my saga. Has your new pdoc come up with any ideas that you haven't come up with yourself? Anyway, what do you think about your new guy and really, how are you doing? I've missed you. Shellie


After 3 1/2 years of experimenting, I take Nardil, Wellbutrin, Vivactil, Dexedrine, risperdal and yohimbe. For me, they work together -- I can't leave anything out.

 

Re: any experience/knowledge of augmenting MAOI's?? » shellie

Posted by SLS on October 18, 2000, at 6:42:38

In reply to Re: any experience/knowledge of augmenting MAOI's?? » SLS, posted by shellie on October 15, 2000, at 23:21:34

Dear Shellie,

I'm glad you have experienced an immediate boost with Nardil. This doesn't surprise me, as this has also been my experience a few times. Nardil and Parnate do other things in addition to inhibiting the enzyme monoamine-oxidase. I don't know exactly what Nardil does, but your boost certainly is not the result of inhibition of MAO. Whatever it does do is what contributes to how well Nardil works for you. The initial boost may not last, and you will have to wait until later to get the full effect. For now, enjoy it. Cut your grass. Cut my grass.

I am disappointed with the way I have been feeling over this last week. I was hoping to get more out of Parnate + desipramine this time. The last few days pretty much sucked. Yesterday, it was like I wasn't taking anything at all.

I really like my new doctor. I need more to become familiar with him than he does me. He has a different way of working that will require that I learn more patience. It's hard to be patient, though, when all you want to do is pull your hand from the flame. I can tell that he has some definite ideas as the direction he wants to go. I think I'll let him lead the way.

With Nardil, I have had a great deal of trouble when combining it with a tricyclic. Last time, I tried to combine it with imipramine, and could not stand up. No exaggeration. I needed someone to help me walk from room to room. If I had known this potential, I would have started Nardil much more slowly. I think it could have made a difference. SLOW - like maybe 30mg for two weeks, 45 for two weeks, etc. If you need to add Serzone, and know its potential to produce hypotension when combined with Nardil, you may want to try a similar strategy. It may take you three or four weeks to reach a therapeutic dosage, but you might be able to establish the Serzone without provoking the body into a reaction.

Hoping you don't need to...


Love,
Scott

 

Re: any experience/knowledge of augmenting MAOI's??

Posted by John D. on January 4, 2001, at 16:31:09

In reply to Re: any experience/knowledge of augmenting MAOI's?? » JohnM, posted by shellie on October 15, 2000, at 15:45:18

> > I presently take Nardil. It worked well for me years ago, but not so much lately. Any input would be appreciated. John
>
>
> John, I wrote the following post a couple of months ago to someone else who answered the same question, so I thought I'd copy it here for you:
>
> >I'm going to give you all the information that I gathered since January, when I felt the nardil lost effectiveness, since some part of it may be helpful to you. I'll try to condense.
>
> In Feb did a trial of sam-e with Nardil, with on the phone supervision with a physician affiliated with Columbia U. who wrote a book on sam-e. He gave sam-e a 70% change of working. Unfortunately, it was not good for me--it made me more depressed and very agitated. But if you look at the sam-e board at www.delphi.com a lot of people who had tried lots of prescription meds, had enormous success with it.
>
> He also said if the sam-e didn't work, these would be his recommendations to try with nardil:
>
> 1. thyroid, add 25 mc of cytomel (t3) for 2 weeks; can try 37.5 also
> ***2. lamcital- (anti-seizure medication) have to go up very very slowly„over a 3 month period--
> 3. add very low lithium level (works 50% of time)„
> 4. add traxedone (deserel)
> 5. add pindolol
> 6. add ridlin or dexadrine or adderall
>
> Because my pdoc was unwilling to experiment, I also consulted with a pdoc at NIMH by phone (very helpful) and with my old pdoc, who was no longer
> accepting my insurance.
>
> The first choice of all three was lamictal. In the last" MAOI doesn't work anymore" thread, I explained that lamictal worked for me really well, but I was gaining weight. A very small percent of people gain weight on lamictal. I was unlucky and unwilling to accept a weight gain since there were other things for me to try. But I think it is very significant that all three doctors I consulted with, picked that as their first choice. >
>
> Anyway, since that post I've tried the following augmentors with nardil (all unsuccessfully)
> aricept
> naltrezone
> provigal
> topmax
> stimulents: ritalin, dexadrine
> resperadone speech slurred)
> amisulpride french anti-psychotic
> adrafinil (french stimulent-had seratone reaction with combination--I don't recommend).
>
> After getting off of nardil and trying serzone, I am now back on nardil and am adding some serzone. If I were you, my first choice would be lamictal, since it was recommended for me to try independently by three different doctors and it worked. (And very few people gain weight on it). Or deseral.
>
> Good luck, hope I didn't overwhelm you. Shellie
>
>
> I have been experiencing a parital relief of depressive symptoms with Nardil ever since I have been taking it (@90mg/d). Although this was initially satisfactory, I have found it very difficult to maintain a normal life at my present level of mental health. Although I get along with my pdoc very well, he has made it clear to me that he doesn't get involved with MAOI polypharmacy. When I related this situation to another mental health pro, he suggested I go out of town for my treatment (he stated that it was unlikely I would be able to find anyone in town who would do differently than my pdoc). I then asked my primary MD to make an appointment for me at a university's medical school. I was informed the pdoc I requested to see was retired. I would still like to see someone who is experienced with treatment-resistant depression, but my inquiries in this direction have been less than fruitful. I loathe to make an appointment based on a haphazard approach, but I'm not sure where to go next. BTW, how do phone consultations work? I saw a posting regarding one with a pdoc @ the NIMH, and I think it could be worth a try.


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