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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Medline on September 26, 2008, at 5:12:21
Nardil (phenelzine) is considered the single most effective, non-addicting drug for Social Anxiety. It works by elevating levels of Serotonin, Dopamine, Norepinephrine and GABA. I think that combining a Selective Serotonin Reuptake Inhibitor (escitalopram) with a Norepinephrine-Dopamine reuptake inhibitor (Bupropion) and a GABA reuptake inhibitor (tiagabine) might be a modern and safe Nardil-substitute. What do you think?
Posted by med_empowered on September 26, 2008, at 6:17:14
In reply to Nardil-substitute, posted by Medline on September 26, 2008, at 5:12:21
hey. What's up? Could you try EMSAM+ a benzo? Or are benzos completely a no-go for you? If they're a total no go, I'd do EMSAM+Lyrica. Lyrica is a controlled substance, but its Schedule V (I think that's where codeine cough syrup is, so I wouldn't worry too much about it).
Have you ever tried Remeron? It seems like Remeron+Wellbutrin+GABA-ergic med(s) might be a good call, and you could probably avoid some of the probs associated w/ SRI drugs.
Posted by bleauberry on September 26, 2008, at 10:28:44
In reply to Nardil-substitute, posted by Medline on September 26, 2008, at 5:12:21
> Nardil (phenelzine) is considered the single most effective, non-addicting drug for Social Anxiety. It works by elevating levels of Serotonin, Dopamine, Norepinephrine and GABA. I think that combining a Selective Serotonin Reuptake Inhibitor (escitalopram) with a Norepinephrine-Dopamine reuptake inhibitor (Bupropion) and a GABA reuptake inhibitor (tiagabine) might be a modern and safe Nardil-substitute. What do you think?
Nope. Totally different mechanisms. Unequal in terms of how much neuros are increased. Very different points of interuption in the neuro biochemistry. Many effects of these meds are unknown or unstudied. Wellbutrin for example is tied into other things such as nitric oxide and nicotinic receptors which may have more to do with its mechanism than norepinephrine or dopamine, since its reuptake inhibition strength of those neuros is actually very weak. The whole neurotransmitter thing is theory, not proven fact, and may be just a tip of the iceberg of what these meds really do to gene instruction, hormone regulation, immune interaction, and such.
Would someone respond real well to the meds you mentioned? Sure. Would they not respond at all? Sure. Would they get a lot worse? Sure. All of the above could happen. Is it a reasonable alternative to Nardil. Imo, No.
Posted by med_empowered on September 26, 2008, at 19:12:56
In reply to Re: Nardil-substitute, posted by med_empowered on September 26, 2008, at 6:17:14
There's a whole lot we dont know about how and why antidepressants work (when and if they work). If you've responded well to Nardil in the past, could you give it another go? I seem to recall reading someplace that adding in a low-dose of certain tricyclics actually reduces the risk of a hypertensive reaction (I think if you check out Ivan Goldberg's writings there will be more info on that).
Can you not just pop a benzo? That's quite possibly the safest and cheapest way to treat anxiety the world has ever seen. Even xanax xr is generic at this point (I think..) so unless you want dissolving xanax or klonopin wafers you can get your meds really, really cheap.
A lot of docs are benzo-phobic. Honestly, benzos can suck if you use them at a high enough dose for a long enough period of time, but if you can low-dose it and/or only take them as-needed, they're amazingly effective, dirt cheap, and really, really, safe.
There's also Niacinamide, which is kind of like natural valium if you take enough (I take 4 grams daily myself, and I can tell you that it works really nicely).
Good luck.
Posted by Tomatheus on September 27, 2008, at 0:13:32
In reply to Nardil-substitute, posted by Medline on September 26, 2008, at 5:12:21
I agree with Bleauberry. Irreversibly inhibiting the MAO enzymes does more than elevate levels of serotonin, norepinephrine, and dopamine. Irreversibly inhibiting MAO-B decreases the metabolism of phenylethylamine and benzylamine, and irreversibly inhibiting both enzymes reduces the amount of ammonia and hydrogen peroxide that are produced by monoamine oxidization. Inhibiting the reuptake of the monoamines and GABA would elevate the levels of these chemicals from an entirely different mechanism and would likely produce different results. I know from my own experiences that taking reuptake inhibitors has been much different from taking MAOIs, although I never tried combining as many different reuptake inhibitors as you're proposing.
Tomatheus
> Nardil (phenelzine) is considered the single most effective, non-addicting drug for Social Anxiety. It works by elevating levels of Serotonin, Dopamine, Norepinephrine and GABA. I think that combining a Selective Serotonin Reuptake Inhibitor (escitalopram) with a Norepinephrine-Dopamine reuptake inhibitor (Bupropion) and a GABA reuptake inhibitor (tiagabine) might be a modern and safe Nardil-substitute. What do you think?
Posted by desolationrower on September 27, 2008, at 11:42:49
In reply to Re: Nardil-substitute » Medline, posted by Tomatheus on September 27, 2008, at 0:13:32
The closest to your combination i had was bupropion plus venlafaxine. That was miles away from tranylcypromine.
-d/r
Posted by jedi on September 27, 2008, at 19:50:42
In reply to Nardil-substitute, posted by Medline on September 26, 2008, at 5:12:21
> Nardil (phenelzine) is considered the single most effective, non-addicting drug for Social Anxiety. It works by elevating levels of Serotonin, Dopamine, Norepinephrine and GABA. I think that combining a Selective Serotonin Reuptake Inhibitor (escitalopram) with a Norepinephrine-Dopamine reuptake inhibitor (Bupropion) and a GABA reuptake inhibitor (tiagabine) might be a modern and safe Nardil-substitute. What do you think?
Hi,
I've been through 45+ different combinations, including mixing bupropion with Nardil-though contraindicated. For my atypical depression and social anxiety there was nothing like Nardil. Amazing that a 50 year old medication can work so well for some people. Just shows you how little we have learned about the complex biological computer called the human brain.
Jedi
Posted by aabag on October 2, 2008, at 2:34:50
In reply to Re: Nardil-substitute » Medline, posted by jedi on September 27, 2008, at 19:50:42
> > Nardil (phenelzine) is considered the single most effective, non-addicting drug for Social Anxiety. It works by elevating levels of Serotonin, Dopamine, Norepinephrine and GABA. I think that combining a Selective Serotonin Reuptake Inhibitor (escitalopram) with a Norepinephrine-Dopamine reuptake inhibitor (Bupropion) and a GABA reuptake inhibitor (tiagabine) might be a modern and safe Nardil-substitute. What do you think?
>
> Hi,
> I've been through 45+ different combinations, including mixing bupropion with Nardil-though contraindicated. For my atypical depression and social anxiety there was nothing like Nardil. Amazing that a 50 year old medication can work so well for some people. Just shows you how little we have learned about the complex biological computer called the human brain.
> Jedi
>*disclaimer this is not my account, but Im using it as its my bro*
I haven't used 45 combo's like you Jedi...around 20 to 25 ones. However I agree. I had a hypomanic episode, followed by the medication "pooping out" so to speak.
Nothing else worked, which leads me to believe that Anti-depressants don't really treat certain types of depression in the first place.Im on something that works better than everything but Nardil, which is Suboxone. It's not an antidepressant....yet it works and it hasn't pooped out or become addictive. I suggest people who have treatment resistant depression look into it. It worked for me and I felt I owed it to everyone here to come back and let everyone know that it did.
I've been through what you guys are all describing, very few people deserve to go through or experience a significant portion of their life like this, let alone their whole life. I believe that it may take 5 years a decade or even 15 years, but stuff will come out and people will get better.
Posted by jedi on October 2, 2008, at 19:56:18
In reply to Re: Nardil-substitute, posted by aabag on October 2, 2008, at 2:34:50
Hi,
If I could have gotten access to buprenorphine, I would have tried it years ago. Getting the medication outside of a drug treatment center is next to impossible. If more research were done with this medication on depression, it would probably prove to be a miracle drug for many treatment resistant people. Too bad our government is so backwards when it comes to research with opioids and other scheduled substances for depression treatment.
JediSuboxone
Generic Name: buprenorphine and naloxone (byoo PREH nor feen and NAH lox own)
What is Suboxone?
Buprenorphine is an opioid medication. Buprenorphine is similar to other opioids such as morphine, codeine, and heroin however, it produces less euphoric ("high") effects and therefore may be easier to stop taking.Naloxone blocks the effects of opioids such as morphine, codeine, and heroin. If Suboxone is injected, naloxone will block the effects of buprenorphine and lead to withdrawal symptoms in a person with an opioid addiction. When administered under the tongue as directed, naloxone will not affect the actions of buprenorphine.
Suboxone is used to treat opiate addiction.
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> *disclaimer this is not my account, but Im using it as its my bro*
>
> I haven't used 45 combo's like you Jedi...around 20 to 25 ones. However I agree. I had a hypomanic episode, followed by the medication "pooping out" so to speak.
>
>
> Nothing else worked, which leads me to believe that Anti-depressants don't really treat certain types of depression in the first place.
>
> Im on something that works better than everything but Nardil, which is Suboxone. It's not an antidepressant....yet it works and it hasn't pooped out or become addictive. I suggest people who have treatment resistant depression look into it. It worked for me and I felt I owed it to everyone here to come back and let everyone know that it did.
>
> I've been through what you guys are all describing, very few people deserve to go through or experience a significant portion of their life like this, let alone their whole life. I believe that it may take 5 years a decade or even 15 years, but stuff will come out and people will get better.
>
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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Script revised: February 4, 2008
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