![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by EERRIICC on September 15, 2004, at 21:34:11
Scott, can I combine memantine and parnate? Going to try ritalin with parnate and wondered if adding memantine would stop ritalin's effects from diminishing.
Thanks, Eric
Posted by SLS on September 16, 2004, at 7:10:39
In reply to To SLS, posted by EERRIICC on September 15, 2004, at 21:34:11
> Scott, can I combine memantine and parnate? Going to try ritalin with parnate and wondered if adding memantine would stop ritalin's effects from diminishing.
>
> Thanks, Eric
I know if it were me, I wouldn't hesitate to add it in. That's about as much of an endorsement as I can offer. I won't go so far as to give it the final seal of approval.Some doctors will take the position that there is not enough data indicating for the safe combining of memantine with an MAOI. However, there is nothing about the mechanisms of memantine that I can think of that would cause an adverse interaction. Memantine does not inhibit the reuptake nor promote the release of any neurotransmitter. The only receptor that it interacts with is the NMDA glutamate receptor. There is no precedent for the induction of a hypertensive reaction or serotonin syndrome. So far, nothing has been reported on Medline.
- Scott
Posted by zeugma on September 16, 2004, at 17:51:41
In reply to Re: To SLS, posted by SLS on September 16, 2004, at 7:10:39
> > Scott, can I combine memantine and parnate? Going to try ritalin with parnate and wondered if adding memantine would stop ritalin's effects from diminishing.
> >
> > Thanks, Eric
>
>
> I know if it were me, I wouldn't hesitate to add it in. That's about as much of an endorsement as I can offer. I won't go so far as to give it the final seal of approval.
>
> Some doctors will take the position that there is not enough data indicating for the safe combining of memantine with an MAOI. However, there is nothing about the mechanisms of memantine that I can think of that would cause an adverse interaction. Memantine does not inhibit the reuptake nor promote the release of any neurotransmitter. The only receptor that it interacts with is the NMDA glutamate receptor. There is no precedent for the induction of a hypertensive reaction or serotonin syndrome. So far, nothing has been reported on Medline.
>
>
> - Scotthi scott,
i was very happy to see that you had some improvement on cymbalta. I wanted to ask you what your experiences with ritalin have been like, and in particular if you had ever combined Ritalin with a TCA. Thanks, z
Posted by SLS on September 17, 2004, at 17:23:14
In reply to Re: To SLS » SLS, posted by zeugma on September 16, 2004, at 17:51:41
Hi Zeugma.
> i was very happy to see that you had some improvement on cymbalta.
Thanks. :-)
> I wanted to ask you what your experiences with ritalin have been like,
Ritalin really didn't help. I remember feeling a little wired, but without an increase in positive energy.
> and in particular if you had ever combined Ritalin with a TCA.
I wish I could remember what I added it to. I think it was added to a combination of Parnate + desipramine.
Why do you ask? If you are looking to extend the stimulatory action of Ritalin and prevent tolerance, you can go ahead and try memantine (Namenda) and see if all of the hype in the medical literature has any merit. Of course, desipramine is much cheaper.
- Scott
Posted by zeugma on September 17, 2004, at 19:37:33
In reply to Re: To SLS » zeugma, posted by SLS on September 17, 2004, at 17:23:14
If you are looking to extend the stimulatory action of Ritalin and prevent tolerance, you can go ahead and try memantine (Namenda) and see if all of the hype in the medical literature has any merit. Of course, desipramine is much cheaper.
I am concerned about tolerance, yes. But my question was really driven by an anxiety attack yesterday that I now realize was not related to either the TCA or the Ritalin, but had more to do with a girl in my vicinity :)Do you think that desipramine has memantine-like antitolerance effects? I suppose nortriptyline would be similar? In any case I will definitely investigate memantine in the next few months. How would you characterize its effect on you?
Thanks again,
-z
Posted by SLS on September 19, 2004, at 7:26:31
In reply to Re: To SLS » SLS, posted by zeugma on September 17, 2004, at 19:37:33
Hi Zeugma.
Sorry about the lateness of this reply.
> Do you think that desipramine has memantine-like antitolerance effects?
I wouldn't think so. The effects of memantine might be mediated through the modulation of neuroplasticity via blockade of NMDA receptors and the resulting reduction of glutamatergic neurotransmission.
> I suppose nortriptyline would be similar? In any case I will definitely investigate memantine in the next few months. How would you characterize its effect on you?
I began taking memantine 20mg while I was already taking imipramine 300mg and Lamictal 300mg. I experienced an unequivicol antidepressant response within the first few weeks. It lasted for less than a week. I have continued with it because it has allowed me to reduce the dosage of Lamictal to 150mg, thus reducing the adverse cognitive side effects it was producing. Also, I was hoping it might help make Cymbalta "stick" in a fashion similar to an antitolerance effect. Of course, I have no scientific evidence that this should happen, but I don't think it could hurt.
I remember quite clearly the experience of one poster who added memantine to Adderall. Prior to adding it, it was necessary for him to cycle on and off Adderall every three or four days in order to recapture its stimulant/antidepressant effect. Upon adding memantine, this was no longer necessary. He was able to take Adderall continuously, and described a "smoother" response to it.
- Scott
Posted by zeugma on September 19, 2004, at 16:42:15
In reply to Re: To SLS » zeugma, posted by SLS on September 19, 2004, at 7:26:31
I remember quite clearly the experience of one poster who added memantine to Adderall. Prior to adding it, it was necessary for him to cycle on and off Adderall every three or four days in order to recapture its stimulant/antidepressant effect. Upon adding memantine, this was no longer necessary. He was able to take Adderall continuously, and described a "smoother" response to it.
That's interesting. My main worry is that I will not be able to sustain therapeutic effects of Ritalin, and it really is *essential* to my proper functioning. I can literally hear the 'noise' in my brain increase when the Ritalin wears off. Or to use a visual analogy, it's like the projector starts to break down and the images on the screen fade out of focus. I will bring up memantine to my pdoc, if not at my next appt. (i don't think I've reached an appropriate dose of Ritalin yet [at 20 mg LA formulation, which lasts about 6 hours, which is not ideal for my work circumstances either]), then at one where my dosage is appropriate: I think that the fear of tolerance is reasonable.
Thanks again, very much, and very glad that you have continued to notice improvements from Cymbalta.
-z
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.