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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by james_glasgow on November 21, 2004, at 17:21:18
Hi there,
I have just come off of Escitalopram after a bad reaction and I am considering asking my GP if I can go back to taking Parnate. I have taken it before on two occassion each for between six and seven months. The main problems I suffered from were insomnia and losing too much weight (although initially the weight loss was helpful as I had put on 56 pounds from 6 years of SSRI use) , so I was thinking of adding in Mirtazapine (Remeron / Zispin). Has anyone had any experience with this combination or found any other drugs to help with Parante induced insomnia in particular.
Thanks,
James
Posted by sfy on November 21, 2004, at 19:33:56
In reply to Parnate and Mirtazapine Combo, posted by james_glasgow on November 21, 2004, at 17:21:18
I don't have personal experience with this combo but I have read that it's OK and can be effective.
"Mirtazapine can be used safely in combination with MAOIs, and the agent has been reported to acutely treat serotonin syndrome"
http://www.currentpsychiatry.com/2002_06/06_02_maoi.asp,
Posted by Willyee on November 22, 2004, at 0:01:18
In reply to Parnate and Mirtazapine Combo, posted by james_glasgow on November 21, 2004, at 17:21:18
> Hi there,
>
> I have just come off of Escitalopram after a bad reaction and I am considering asking my GP if I can go back to taking Parnate. I have taken it before on two occassion each for between six and seven months. The main problems I suffered from were insomnia and losing too much weight (although initially the weight loss was helpful as I had put on 56 pounds from 6 years of SSRI use) , so I was thinking of adding in Mirtazapine (Remeron / Zispin). Has anyone had any experience with this combination or found any other drugs to help with Parante induced insomnia in particular.
>
> Thanks,
>
> James
I have used it,parnate seems most active within the few hours taking it,which can make for a possably serious situation if a interacting food,med etc is ingested at that time.However because of this,id assume bedtime would be quite a few hours past your last parnate dose,whereas taking remeron shouldent have any bad interaction,and the parnate taken earlier will not prevent remerons sedative properties to go into play,i always went into a hybersleep with any dose of remeron.
I personaly dident have any interaction with it what so ever,in fact the parnate dose in morning helped me come out of the remeron fog which felt like i was on some heavy drugs and could never come out of,parnate started to work and my eyes would open,no head strain,or feeling of a possable interaction at all.
I personaly did not like the sleep remeron provided,it was zombie like,and i could not tolerate it,but from my experieance and mine only of course,i can say for me i did not notice any interaction,and did not have any fear of using the combo.
Melatonin,however i did not feel worked with parnate,i did feel with that,a minor i guess would be called serontion syndrome,i felt something,not particulary bad,just enough to not feel comfortable enough to use it.
Posted by King Vultan on November 22, 2004, at 8:29:33
In reply to Parnate and Mirtazapine Combo, posted by james_glasgow on November 21, 2004, at 17:21:18
Theoretically, there is a risk from Remeron's alpha-2 adrenergic blockade releasing norepinephrine (and perhaps serotonin--don't have my reference with me today and can't remember exactly), but trazodone has the same blockade and is widely used for MAOI insomnia. I think it's probably okay, but I think it's a good idea to start out at a low level of a drug like this just in case there are adverse effects. Surmontil/trimipramine, which is a sedating tricyclic, might also be worth considering, and I believe this is perfectly safe to use with an MAOI because it has no obvious way of releasing any additional amines. Doxepin is a little riskier but is also probably still okay. It would have a greater tendency to induce weight gain than Surmontil; although, I believe the latter drug would also have some ability to do so.
Todd
Posted by james_glasgow on November 22, 2004, at 9:21:32
In reply to Re: Parnate and Mirtazapine Combo, posted by King Vultan on November 22, 2004, at 8:29:33
Hi there,
I have an appointment with my GP tomorrow morning to discuss this, think I might be onto a bit of a long shot with a script for Parnate and Zispin, but he might at a push let me try it with a sedating TCA in the evening.
Thanks again,
James
This is the end of the thread.
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