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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 medtrier on December 9, 2010, at 7:56:48
Hi,
I am currently on generic Parnate, 90 mg./day. Although it helps, it doesn't do enough for my multiple health symptoms, which would be best classified as "atypical depression."
My doctor doesn't want to go above 90, esp. since the appvoved max. is 60.
I am looking for drugs that can be added to Parnate. I know it's tricky, since parnate is an MAOI, and MAOI's tend to be contraindicated with most other drugs, even Remeron. But remeron doesn't seem like it would interact badly.
So far I have tried abilify, which basically made things somewhat worse for me.
I have also been on risperidone (risperdal), and reacted badly to it. This was back when i was on lexapro.
I suppose i could try zeprexa or seroquel, but i have little desire to try antispsychotics since i am 0 for 2 on them so far, and out of the 14 drugs i have tried, they are the only ones that make me feel worse.
I was thinking about guanfacine, which is now marketed for ADHD under the new name "intuniv". It's a alpha andrenergic blocker like remeron, but doesn't mess with serotonin at all. I tried one week at 1 mg., and a week at 2 mg. of intuniv, with no luck. But that's a really low dose.
Beta blockers may be a choice as well, as anxiety is one of the problems, but not the usual type of anxiety.
I have heard on this message board that some people's doctors have mixed MAOI's with SSRI's without anything bad happening, but I doubt my doctor would go along with that.
Also, if anyone knows of psychiatrists they can recommend in the Philly-Wilmington-Lancaster-Baltimore area, that would be much appreciated.
Thanks,
Medtrier
Posted by Dr. Bob on December 12, 2010, at 2:41:30
In reply to drugs to combine with MAOI's, posted by medtrier on December 9, 2010, at 7:56:48
> I am looking for drugs that can be added to Parnate.
To consolidate replies, I'd like to redirect this thread to Psycho-Babble Medication. Here's a link:
http://www.dr-bob.org/babble/20101203/msgs/973129.html
Thanks,
Bob
Posted by desolationrower on December 28, 2010, at 23:09:14
In reply to drugs to combine with MAOI's, posted by medtrier on December 9, 2010, at 7:56:48
You should describe the symptoms that need treated, or else its just a dialogue of 'q:I have problems a:- take some drugs'
I would be some what worried about remeron alpha 2 antagonism. More worried that say AMP, since I haven't seen anything published on maois with a2 antagonist s.
Anyway most drugs are ok, so with more info some mpre options should be available
Posted by desolationrower on March 23, 2011, at 4:29:45
In reply to Re: drugs to combine with MAOI's, posted by desolationrower on December 28, 2010, at 23:09:14
its been 3 moths and no posts...
let me just metion that guanfacine is like the #$#JK# opposite of mirtazapine. that is all.
-d/r
Posted by jono_in_adelaide on March 28, 2011, at 3:34:59
In reply to drugs to combine with MAOI's, posted by medtrier on December 9, 2010, at 7:56:48
Add nortriptyline - combining a TCA with an MAOI was quite common in years gone bye, and it doesnt lead to hypertensive crisis
Start off at Parnate 10mg twice a day and nortriptyline 25mg at night, and build up over a week to parnate 60mg/day and nortriptyline 75mg at night.
If this fails, try Nardil + nortriptyline
Posted by desolationrower on March 30, 2011, at 12:56:55
In reply to Re: drugs to combine with MAOI's, posted by jono_in_adelaide on March 28, 2011, at 3:34:59
i would not change dosages of the tca and maoi at the same time.
Get on one at a steady dose in the usual clinical range, then when you decide that isn't working, add the second one.
-d/r
Posted by James H on April 29, 2011, at 17:02:57
In reply to Re: drugs to combine with MAOI's, posted by desolationrower on March 30, 2011, at 12:56:55
> i would not change dosages of the tca and maoi at the same time.
>
> Get on one at a steady dose in the usual clinical range, then when you decide that isn't working, add the second one.
>
Stahl recommends combing a low dose of the MAOI and a low dose of the tricyclic and raising each together until achieving therapeutic doses of each, in his "Prescibers Guide to Antidepressants".
Posted by desolationrower on June 24, 2011, at 21:12:41
In reply to Re: drugs to combine with MAOI's, posted by James H on April 29, 2011, at 17:02:57
> > i would not change dosages of the tca and maoi at the same time.
> >
> > Get on one at a steady dose in the usual clinical range, then when you decide that isn't working, add the second one.
> >
> Stahl recommends combing a low dose of the MAOI and a low dose of the tricyclic and raising each together until achieving therapeutic doses of each, in his "Prescibers Guide to Antidepressants".
>
>haha. I like is pictures, but that is a bad idea.
-d/r
Posted by desolationrower on June 24, 2011, at 21:12:46
In reply to Re: drugs to combine with MAOI's, posted by James H on April 29, 2011, at 17:02:57
> > i would not change dosages of the tca and maoi at the same time.
> >
> > Get on one at a steady dose in the usual clinical range, then when you decide that isn't working, add the second one.
> >
> Stahl recommends combing a low dose of the MAOI and a low dose of the tricyclic and raising each together until achieving therapeutic doses of each, in his "Prescibers Guide to Antidepressants".
>
>haha. I like is pictures, but that is a bad idea.
-d/r
This is the end of the thread.
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