Posted by Elizabeth on June 9, 2000, at 4:22:38
In reply to Re: history and pharmacists » Elizabeth, posted by SLS on June 3, 2000, at 9:26:37
> I don't think pargyline is terribly effective as an antidepressant.
Dunno, never tried it :)
> One reason may be that it is fairly selective for MAO-B. An interesting lessen in trying to infer drug activities based upon molecular heritage (not that you need one) is that a propargyl cousin of pargyline, deprenyl is also selective for MAO-B, while another cousin, clorgyline, is specific for MAO-A.
Whatever happened to clorgyline, anyway? I don't think it was ever in clinical use for anything.
> > BTW, I wouldn't necessarily trust anything a pharmacist said about MAOIs. IME, they tend to get a lot of things wrong, especially in regard to interactions; I pretty much feel I can count on them to parrot the PDR (though there are exceptions). I attribute this to a lack of real clinical experience.
>
> Except for Cam W. :-)Definitely falls under "though there are exceptions!"
> Does Mirapex, or any of the other DA agonists, potentiate the hypotensive effect of Nardil or any of the other MAOIs? I didn't experience this when I added Parlodel to Parnate + desipramine.
I have no idea! (Did the Parlodel do anything useful, BTW?)
> Oh, and while I've got you here, I'm having trouble deciding whether to use Nardil or Parnate for treating my bipolar depression. I am aware of the traditional choice of Parnate in this situation.
Really? I'm not.
> However, having experienced a partial response to both, I like the way I feel on Nardil better.
Go with it, then.
> It is becoming increasingly apparent that anhedonia can persist in many people who otherwise respond robustly to Parnate.
OH *YEAH*. (Although actually I have to say, most of my other symptoms are still here too, though somewhat improved. The only thing that is a lot better is mood.)
> A confounding factor is that I will be using a tricyclic along with either MAOI. I experience one hell of a synergism between Nardil and a tricyclic with regard to hypotension and the ability to initiate urination. Imipramine is out, although it is probably more effective. I will be using desipramine, and will be throwing in as much other crap as I can find.
Those anticholinergic effects will get you every time (at least, they got me every time).
> Any suggestions?
>
> Any opinions on Gabitril?No clue -- that's an interesting one. Huh. I mean, my thought when I first read of how it works was, "hey, has this been tried for anxiety?" But I don't know anyone who's actually taken it.
> What is your gut-reaction to Tegretol?
I think it's worth a try, but you do have to monitor your white cells and liver enzymes. Actually I was talking to my pdoc just today (err, yesterday) about whether it would be worth it for me to try Tegretol if the lithium doesn't work any magic, and he thought it would be. He mentioned that he's used it as a PRN for anxiety, which I thought was interesting, and he thought it might help with the insomnia.
> I will be eternally grateful if you would be kind enough to cure me.
I don't think kindness is always enough! :)/:( But I'm always willing to contribute whatever I can.
poster:Elizabeth
thread:34894
URL: http://www.dr-bob.org/babble/20000603/msgs/36675.html