Posted by SLS on August 16, 2005, at 8:14:09
In reply to Re: TCAs, irritability, and BPD., posted by tygereyes on August 15, 2005, at 21:14:18
> > > Lately I have really been thinking that Parnate might help with some of these symptoms, though, so perhaps there is hope. >>
> > >
> > > At one time Parnate was the first line treatment for BPD. (I am quoting the illustrious SLS from memory and any errors in transcription are mine.)
> > >
> > > -z
> >
> >
> >
> > You devil, you!
> >
> >
> >
> >
> > 1: Arch Gen Psychiatry. 1988 Feb;45(2):111-9. Related Articles, Links
> >
> >
> > Pharmacotherapy of borderline personality disorder. Alprazolam, carbamazepine, trifluoperazine, and tranylcypromine.
> >
> > Cowdry RW, Gardner DL.
> >
> > Intramural Research Program, National Institute of Mental Health, Bethesda, MD 20892.
> >
> > Sixteen female outpatients with borderline personality disorder and prominent behavioral dyscontrol, but without a current episode of major depression, were studied in a double-blind, crossover trial of placebo and the following four active medications: alprazolam (average dose, 4.7 mg/d); carbamazepine (average dose, 820 mg/d); trifluoperazine hydrochloride (average dose, 7.8 mg/d); and tranylcypromine sulfate (average dose, 40 mg/d). Each trial was designed to last six weeks. Tranylcypromine and carbamazepine trials had the highest completion rates. Physicians rated patients as significantly improved relative to placebo while receiving tranylcypromine and carbamazepine. Patients rated themselves as significantly improved relative to placebo only while receiving tranylcypromine. Patients who tolerated a full trial of trifluoperazine showed improvement, those receiving carbamazepine demonstrated a marked decrease in the severity of behavioral dyscontrol, and those receiving alprazolam had an increase in the severity of the episodes of serious dyscontrol. As an adjunct to psychotherapy, pharmacotherapy can produce modest but clinically important improvement in the mood and behavior of patients with borderline personality disorder. As a research tool, patterns of pharmacological response may provide clues to biological mechanisms underlying dysphoria and behavioral dyscontrol.
> >
> > Publication Types:
> > Clinical Trial
> > Randomized Controlled Trial
> >
> > PMID: 3276280 [PubMed - indexed for MEDLINE]
> >
>
> I actually read that study recently, when researching Parnate. It's unfortunate that Tegretol and Parnate are contraindicated [and I'm assuming that Trileptal, which I currently take, is contraindicated as well, but I'm not certain]; the two would seem to pack quite a punch for those with BPD.
I agree. I know of no reason why Parnate could not be combined with Tegretol or Trileptal. Until this week, I had been combining Parnate 80mg + Trileptal 900mg.I think some of the "contraindication" is nothing more than a simplistic fear that any drug with a tricyclic structure should be avoided when taking a MAOI and does not take into account the actual pharmacology of the drugs.
- Scott
poster:SLS
thread:540851
URL: http://www.dr-bob.org/babble/20050816/msgs/542382.html