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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by davidla on January 8, 2009, at 22:54:20
I take Nardil and my new psydoc prescribed me Anafranil for my OCD symptoms. Is this a safe combination?
I researched this online and all I'm seeing are warnings that these meds should never be combined.
Thanks,
DLA
Posted by Sigismund on January 8, 2009, at 23:38:37
In reply to Is it safe to take Nardil and Anafranil?, posted by davidla on January 8, 2009, at 22:54:20
>Is this a safe combination?
No, I don't think so.
Posted by Phillipa on January 9, 2009, at 0:33:18
In reply to Re: Is it safe to take Nardil and Anafranil?, posted by Sigismund on January 8, 2009, at 23:38:37
I'd say no also. Could be wrong???? Love Phillipa
Posted by emilio on January 9, 2009, at 7:14:13
In reply to Re: Is it safe to take Nardil and Anafranil?, posted by Phillipa on January 9, 2009, at 0:33:18
no very dangerous
Posted by SLS on January 9, 2009, at 10:48:36
In reply to Is it safe to take Nardil and Anafranil?, posted by davidla on January 8, 2009, at 22:54:20
> I take Nardil and my new psydoc prescribed me Anafranil for my OCD symptoms. Is this a safe combination?
>
> I researched this online and all I'm seeing are warnings that these meds should never be combined.MAOIs can be combined with desipramine, nortriptyline, and perhaps trimipramine, but not clomipramine nor imipramine. The results of mixing potent serotonin reuptake inhibitors with MAOIs is serotonin syndrome. This is a potentially fatal reaction. I am currently taking Parnate + nortriptyline. I have also safely mixed high dosage Parnate with desipramine. Nardil + imipramine will likely produce a moderate serotonin syndrome, whereas Parnate + imipramine is safe. A proper warning would include the fact that everyone's neurochemistry is unique, and what might be tolerable for one person can be poison to another.
What are your plans?
- Scott
Posted by davidla on January 9, 2009, at 21:01:21
In reply to Re: Is it safe to take Nardil and Anafranil? » davidla, posted by SLS on January 9, 2009, at 10:48:36
My first reaction is that my doc is incompetent and possibly dangerous. I assume the pharmacy would not have filled the prescription but that is little consolation.
I am not familar with desipramine, nortriptyline, or trimipramine. My primary reason for taking Anafranil was to reduce my OCD symptoms.
Any suggestions on what I can augment Nardil with in order to treat OCD?
Thanks,
DLA
Posted by SLS on January 9, 2009, at 22:01:23
In reply to Re: Is it safe to take Nardil and Anafranil?, posted by davidla on January 9, 2009, at 21:01:21
Memantine (Namenda) is currently being looked at as an augmenting drug to treat OCD. I believe it would be safe to add it to Nardil.
- Scott
Posted by desolationrower on January 10, 2009, at 1:38:31
In reply to Re: Is it safe to take Nardil and Anafranil?, posted by SLS on January 9, 2009, at 22:01:23
N-acteyl cysteine is also being looked at; its quite cheap (over the counter)
-d/r
Posted by SLS on January 10, 2009, at 3:44:50
In reply to Re: Is it safe to take Nardil and Anafranil?, posted by desolationrower on January 10, 2009, at 1:38:31
> N-acteyl cysteine is also being looked at; its quite cheap (over the counter)
>
> -d/rI did not know that. Pretty cool stuff. I believe there are ongoing studies looking at NAC for bipolar depression.
- Scott
Posted by SLS on January 10, 2009, at 6:09:43
In reply to Re: Is it safe to take Nardil and Anafranil?, posted by desolationrower on January 10, 2009, at 1:38:31
> N-acteyl cysteine is also being looked at; its quite cheap (over the counter)
>
> -d/rDo you have any idea how long someone must take NAC to see benefit when treating OCD?
In general, what are your thoughts on adding NAC to fish oil for OCD or bipolar disorder? I was taking this combination for a few weeks before deciding to make the switch from Nardil to Parnate. Since, by then, I hadn't received any benefit that I was aware of, I discontinued both substances as not to confound my ability to evaluate the results of the med change.
- Scott
Posted by desolationrower on January 10, 2009, at 11:11:25
In reply to Re: Is it safe to take Nardil and Anafranil?, posted by SLS on January 10, 2009, at 3:44:50
and there was the recent study on its effect on schizophrenia, and the ones on cocaine addiction. It definatly interesting due to indication that glutamatergic drugs could be helpful for people who don't get benefit from current monoamine-based treatments. (although the authors thought it was due to glutathione properties??!? ) well and also an affordable alternative to the expensive future drugs.
-d/r
Posted by psychobot5000 on January 10, 2009, at 23:09:38
In reply to Re: Is it safe to take Nardil and Anafranil?, posted by davidla on January 9, 2009, at 21:01:21
> My first reaction is that my doc is incompetent and possibly dangerous. I assume the pharmacy would not have filled the prescription but that is little consolation.
>I would merely add that, well, a doc willing to prescribe tricyclics with MAOis is something some of us would like to have. Granted, in this case, he/she would seem to have gone a bit far...
> I am not familar with desipramine, nortriptyline, or trimipramine. My primary reason for taking Anafranil was to reduce my OCD symptoms.
>
You're in something of a bind, if I understand right. As things are now, it's mostly serotonergic drugs that are used to treat OCD, and precisely those drugs (SSRIs and clomipramine/anafranil) are the ones you can't at all costs, combine with Nardil or other MAOis. I have two tentative suggestions. First, you might try another tricyclic, like trimipramine or nortriptyline or the others people have mentioned. They're not likely to be as effective for OCD as anafranil, but as I understand it, they do help some people. Second...mirtazipine/remeron might be worth trying, in your case, simply because the first line drugs are too dangerous. From what I've read, it's probably as safe or safer than most tricyclic antidepressants when taken with an MAOi (your doc may still have to argue about it with the pharmacists, though), and is -sometimes- useful for OCD--i.e. it was for me, but some patients apparently find it makes their condition worse.So anyway, those are two options you might try for OCD, neither of them very high-percentage shots, but perhaps worth thinking over. I wish you luck.
Posted by davidla on January 11, 2009, at 20:22:20
In reply to Re: Is it safe to take Nardil and Anafranil? » davidla, posted by psychobot5000 on January 10, 2009, at 23:09:38
> So anyway, those are two options you might try for OCD, neither of them very high-percentage shots, but perhaps worth thinking over. I wish you luck.
I appreciate the suggestions. However, taking a new med that has a low probability of working would be difficult, especially when it means yet more side effects (Nardil has terrible side effects).
Ideally, I would like to get off Nardil...but every time I try I end up back on it very quickly. It's like being trapped.
Posted by psychobot5000 on January 12, 2009, at 11:46:37
In reply to Re: Is it safe to take Nardil and Anafranil?, posted by davidla on January 11, 2009, at 20:22:20
>
> I appreciate the suggestions. However, taking a new med that has a low probability of working would be difficult, especially when it means yet more side effects (Nardil has terrible side effects).
>
> Ideally, I would like to get off Nardil...but every time I try I end up back on it very quickly. It's like being trapped....Yeah. My impression (both from my own exerience and reading that of others) is that getting off of MAOis can be a very unpleasant experience. I can identify. Still, it sounds like it might be worth it in the long run, for you--if you can handle a month or six weeks or so of unpleasantness. Perhaps you could speak to your doc about something to help you get off the MAOi? I believe that adding trazodone is something docs used to do during the withdrawal process for MAOis--they felt it helped cushion the blow and was reasonably safe. A doc of mine said the combination was safe.
Maybe then, anafranil would be useful to you on its own (?). For what its worth, I've read that when it was used commonly, anafranil used to be considered a more powerful antidepressant than most, and also very good for OCD. (however, I believe it also has a fair number of side-effects)
Best of luck!
Posted by Neal on January 16, 2009, at 12:36:12
In reply to Re: Is it safe to take Nardil and Anafranil?, posted by davidla on January 11, 2009, at 20:22:20
Is it safe to take Anafranil and suboxone at same time, if anyone knows?
This is the end of the thread.
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