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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by SLS on April 28, 2012, at 6:42:49
Hi B2C.
I hope today is a better day for you.
You don't have to smile if you don't feel like it - at least not here. I just wanted to reiterate what was said along your "I can't even smile" thread. There are plenty of people on Psycho-Babble who can relate to your thoughts and feelings because they have experienced the same things at one time or another.
To answer your question - yes, an MAOI can be combined with a stimulant like Adderal.
http://www.dr-bob.org/tips/split/MAOIs-in-high-doses-and-wi.html
http://www.ncbi.nlm.nih.gov/pubmed/15554766
I have tried both Ritalin and Dexedrine separately in combination with Parnate and desipramine. I also tried Dexedrine in combination with Nardil and nortriptyline. With Parnate, spontaneous hypertension sometimes occurs, although this is infrequent. It is a good idea to monitor your blood pressure at the beginning of combined treatment. My doctor had me wait in his office after my first dose of Dexedrine so as to check my BP. Some doctors actually use stimulants to mitigate the low blood pressure that is the more common side effect of a MAOI. I think Ritalin is used more often for this purpose. I would be more afraid of taking ephedrine, pseudoephedrine, and phenylpropanolamine. According to what I have read, one would want to start the MAOI first and then add the stimulant (Dexedrine or Ritalin) to it later. This is how I have done it.
Unfortunately, there are no large-scale clinical studies of combining MAOI with stimulants. Reports are anecdotal.
Krisko et al. (1969)
Kline et al. (1981)
Feighner et al. (1985)http://www.ncbi.nlm.nih.gov/pubmed/3997787
BTW, Parnate has some therapeutic effects for treating ADD and social anxiety disorder.
It is important to weigh the risks versus benefits of any treatment. Hopefully, your doctor will feel comfortable with using MAOIs.
- Scott
Posted by Phillipa on April 28, 2012, at 10:02:38
In reply to b2chica - How are you today?, posted by SLS on April 28, 2012, at 6:42:49
b2chica wanted to add my wish that you are feeling better and wish you a good day. Phillipa
Posted by b2chica on April 30, 2012, at 8:10:04
In reply to b2chica - How are you today?, posted by SLS on April 28, 2012, at 6:42:49
still around. slept most of weekend. i am saddened that my 'go-to med zyprexa hasnt kicked in. it normally helps within 24-48 hours.
however i did stop the tears. but still feel like a pile of unmoveable slop.just everything is such an effort. even trying to get better is too much work.
and i Hate taking showers when i feel like this.
i took off part of last thursday and most of friday from work and slept all day friday.poor kids watched videos all weekend so lazy me could sleep.
i even want to go home now.
i'll post again if i ever feel better.
thnx
Posted by SLS on April 30, 2012, at 9:00:03
In reply to Re: b2chica - How are you today?, posted by b2chica on April 30, 2012, at 8:10:04
> poor kids watched videos all weekend so lazy me could sleep.
You are not lazy. You are depressed. Depression causes one to feel lazy because one is so sapped of energy and motivation. It is part of the illness, and is not your fault. Words have power, even if you use them only for the thoughts that go on in your head. It is inaccurate to conclude that you are lazy. However, if you say to yourself that you are lazy, then you will come to believe it. If you believe it, your self-esteem will suffer.
Stay strong and believe in yourself. I believe in you. I believe that you persevere to use all of what God has given you to work with. This is an admirable trait. It will help you survive for the day when you find a successful treatment for you illness.
> i even want to go home now.
>
> i'll post again if i ever feel better.
> thnx
You can post again even if you don't feel better.
- Scott
Posted by Dinah on April 30, 2012, at 9:09:48
In reply to Re: b2chica - How are you today?, posted by b2chica on April 30, 2012, at 8:10:04
Do you only take zyprexa when you're in total meltdown? Have you considered taking an AP on a regular scale, or even on an as needed basis earlier in the process? I take my risperdal at the first of those feelings inside that typically come in advance of a meltdown.
In my case, AD's contributed to the problem rather than helped. Anything that was activating made things worse rather than better. Except Provigil, which I didn't find activating so much as just helping keep me awake.
My only three psych meds right now are a low dose mood stabilizer actually taken for migraines, Provigil actually taken for sleep apnea, and low dose as needed Risperdal, which is the linchpin of my regime. I try to balance the benefits and side effects by just taking it as needed, but not being afraid to take it at the earliest sign it's needed. That and therapy are the answer for me, and one of the main issues I had was meltdowns.
Posted by b2chica on April 30, 2012, at 11:12:53
In reply to Re: b2chica - How are you today? » b2chica, posted by Dinah on April 30, 2012, at 9:09:48
Dinah. ive been on many combinations. zyprexa was always one that worked as needed. there were times that i took it longer but the weight gain (at one point 50lbs) was too much to take.
i was on zyprexa 5mg over 5 weeks and upped to 10 last week. still not much.
oh and i take back the crying thing. already had one bout this morning.
i just dont want to try anything new. i dont have the warewithall to sustain going through another failed drug.
i feel that i am a total let down to my pdoc. and cant even pick up the phone to call him.
i know he'd help. i think he would.
but i cant seem to make that call.
i'm afraid he'll change my meds,
i'm afraid he wont
i'm afraid he'll give up on me.
i'm afraid he'll view me different as a failure to his career.
i dont have the, like i cant stand up without a crutch and there is only one crutch and its just out of reach.
Posted by b2chica on April 30, 2012, at 14:20:43
In reply to b2chica - How are you today?, posted by SLS on April 28, 2012, at 6:42:49
Posted by Dinah on April 30, 2012, at 19:47:28
In reply to Re: b2chica - How are you today?, posted by b2chica on April 30, 2012, at 11:12:53
Don't be afraid to call him. It isn't a failure to him, it's a challenge.
Once the cycle starts, it snowballs. You need his help to stop the cycle.
Once this episode is over, maybe it would be possible to track and find early warning signs to ward off full fledge meltdown.
Posted by papillon2 on May 8, 2012, at 2:06:12
In reply to Re: b2chica - How are you today? » b2chica, posted by Dinah on April 30, 2012, at 19:47:28
Posted by b2chica on May 8, 2012, at 9:21:25
In reply to Re: b2chica - thinking of you! (nm), posted by papillon2 on May 8, 2012, at 2:06:12
much appreciated papillon2.
mood wise im still trying to get my head above water. or at least sea level.
but i'm currently dealing with severe tooth pain. i dont know what i did but since sunday been in severe pain. cant get in to dentist till thursday morning. if i bite on left side i get shot to the moon with pain.
not helping mood any.
This is the end of the thread.
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