Posted by JohnL on August 17, 2000, at 5:29:55
In reply to Re:JohnL one more question, please!, posted by Anna P. on August 16, 2000, at 10:16:12
> I appreciate your suggestions. I'm considering what my options are at this point.
> Since I've tried almost everything, my Dr sees only one choice for me - MAIO's. I'm a little bit reluctant because of a heart and chest pain I was getting after dexedrine, and amineptine. I know that Parnate is amphetamine, highly stimulating medication.
> He suggests taking Parnate for my anergic depression. I know this is an excellent choice if not that heart pain. He suggest one week break between Reboxetine and Parnate.
> I am wondering is one week really neccesary, as I've read that Parnate shouldn't really interact with Reboxetine (cheese effect).
>
> What about switching into Parnate from Rebox/Sulpiride combo?
> (Sulpiride works better for me than Amisulpiride).
>
> I appreciate your help.
>
> Anna P.Hi again Anna,
Wow, I had forgotten how many different meds you've already tried. Who knows, an MAOI could end up being the magic. As for the washout period, I have read that this is probably not a major concern as it would be if switching from an SSRI to an MAOI. I would definitely stick to your doctor's advice with anything MAOI-related. Having said that, I wouldn't doubt it if you could even overlap the meds while switching without any washout at all. If I were to do that myself, I would start the MAOI at a very small dose and work it in gradually while tapering off the others. Sometimes we accidentally find a sweet spot during these transitions. But even if not, I think it's possible to avoid a washout in your case, using extra caution by keeping doses very low and being on the lookout for anything troublesome so if there are any problems, you can catch them early.I also wonder what chemistries have been overlooked in your treatment. Probably not many! Let's see...low serotonin. Nope. You've already been there. Low NE. Nope. Treating that now. Low dopamine. Nope. You've tried stimulants and sulpride/amisulpride. Failed NE/dopamine. Nope. Stimulants again. Electrical instability. Nope. Treating now with Neurontin. So what's left? Chemical instability...Lithium? How about EXcess dopamine...antipsychotics???
It just seems to me you've been on all kinds of meds that increase neurotransmitter levels, but haven't been all that successful. An MAOI is going to accomplish the same thing, though in a different way. Maybe that different way will make a good difference. But I wonder. I might instead be inclined to turn my eyes to chemistries that have been missed up to this point. Like excess dopamine for example. We so often think of depression as a neurotransmitter deficiency. But excess levels cause depression too. That's why some people, like me, actually get worse, almost suicidally depressed, when neurotransmitter levels are increased (mainly NE, dopamine somewhat, serotonin somewhat). As we know, people sometimes find a cure for their depression in an antipsychotic when antidepressants failed. That is a chemistry of excess dopamine. Might be worth considering.
So, just one more alternative to add to your short list...perhaps lower the Rebox and Neurontin a little bit, but add in Zyprexa or Risperdal. Zyprexa would be my top choice. Personally I REally like the combination of Adrafinil + Amisulpride. I know you've tried sulpride and amisulpride. But I don't know if you've tried Adrafinil. Regardless, if you've tried either alone, you would be amazed how differently and wonderfully they work together instead of singularly.
Just more stuff to think about. Sorry, I'm just wanting to help, but instead might be making it even more confusing than it already is.
John
poster:JohnL
thread:42844
URL: http://www.dr-bob.org/babble/20000811/msgs/43147.html