Posted by SLS on June 6, 2013, at 17:41:44
In reply to SLS - Do you think less Nardil might help?, posted by gilmourr on June 6, 2013, at 13:39:00
> Hey SLSHi.
You ask brilliant questions.
> I was thinking that by day 70 if Nardil isn't giving me more benefit in the depressive/mood swing area that I might drop it down to 30 mg since it was working much better between days like 20-40.
1. What do you mean by "mood swing"? Can you describe what happens?
2. How much Nardil are you currently taking, and for how long have you been at that dosage?
3. Your improvement between days 20-40 might have been more time dependant than dosage dependant. My guess is that Nardil would have pooped-out on you, regardless of dosage.
4. Nardil does build up in the body at an accelerated rate as the dosage is increased. This is because Nardil inhibits its own metabolism. The difference in effect between Nardil 45mg to 60 mg is greater than Parnate 40 mg to 60 mg. Most people don't respond well to Nardil until they reach a dosage of 60 mg/day. Generally, the more you weigh, the more Nardil you need. A formula that works pretty well is to take 1 mg Nardil per 1 kg body weight. (1 kg = 2.2 pounds).
100 pounds = 45 kg
125 pounds = 56 kg
150 pounds = 68 kg
175 pounds = 79 kg
200 pounds = 91 kgYou can see why most people need a minimum of 60 mg/day of Nardil for it to produce a robust therapeutic effect.
> Is it possible that it was building up in my body (and it was working at 30 mg and not so much once it hit 45 mg) or does a MAO inhibitor usually inhibit the MAO according to dose and not really build up? (neurotransmitter wise)
I don't know how quickly and to what degree neurotransmitter stores are increased once MAO is inhibited.
> Also, do you know what dose of seroquel starts affecting 5HT2A receptors?
Seroquel (quetiapine) is only moderate in its affinity for 5-HT2a receptors and approximates its affinity for D2 receptors. I don't really know at what dosage significant antagonism at these receptors occur, but I imagine one would need more than 100 mg/day. 400 mg/day seems to be the sweet-spot for Seroquel's therapeutic benefits on psychosis and depression. At 100 mg/day and lower, I think its antihistamine (H1 antagonism) effects predominate. Interestingly, Seroquel has relatively stong affinity for NE alpha-1b receptors. This property is also expressed by prazosin. I would not be surprised if Seroquel were to exert some of its antidepressant effect via this receptor.
> I've been using it...3rd day I felt awesome for like 8 hours, but then it died down... I was thinking this might've been the effect on 5HT2A or maybe some hypomanic swing caused by more NET inhibition from norquetiapine. (Though I don't know if I'm BP2, still assuming I'm MDD)
You have used the terms "hypomanic" and "mood swing". These phrases are generally not used by people with unipolar depression to describe their condition. If true hypomania and mood-swings occur, I would be inclined to look more closely at a BD II diagnosis. You may need a mood stabilizer in your treatment regime.
- Scott.
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1044784
URL: http://www.dr-bob.org/babble/20130527/msgs/1044794.html