Posted by Tomatheus2 on June 8, 2007, at 19:08:22
In reply to Combining Provigil and Parnate, posted by malcolm664 on June 8, 2007, at 16:42:13
Malcolm,
According to a case report published in 2004, a patient with narcolepsy was successfully treated with a combination of tranylcypromine (Parnate) and modafinil (Provigil). The combination was well tolerated.
Here's a link to a Web page where you can access the article:
http://linkinghub.elsevier.com/retrieve/pii/S1389945704001145However, according to a case report published in April, a patient developed acute chorea, confusion, and hyperthermia after adding 200 mg of modafinil to 80 mg of tranylcypromine. This may be the report that your doctor was referring to.
The full text of the article can be accessed here:
http://www.ajp.psychiatryonline.org/cgi/reprint/164/4/684Another article published in April reported of a patient experiencing a fever and extrapyramidal side effects after combining modafinil with tranylcypromine. The case report is referenced here:
http://www.ingentaconnect.com/content/adis/rea/2007/00000001/00001148/art00086Considering that there is one documented case of Parnate being combined with Provigil safely, it is likely that some individuals may be able to tolerate the combination. But given the two recent case reports (both published this year) of patients responding adversely to a tranylcypromine-modafinil combo and the fact that the two medications are contraindicated, I think that most doctors would be hesitant to prescribe the two medications together.
Tomatheus
> Hi: I've been on Parnate for the last 6-7 weeks and so far so good, the only problem I'm continuing to have are insomnia and daytime drowsiness. I'm not experiencing any euphoria like I did on Nardil, but it seems to work really well at relieving my anxiety.
>
> I've asked my doc repeatedly about going on Provigil and he keeps saying that he's read one study (!) which says the combination isn't safe.
>
> Now I understand his hesitation with prescribing the amphetamines (Desoxyn, Ritalin, Concerta, etc) with an MAOI, but from everything I've been reading on this board, there are several people who are on Provigil and and MAOI and apparently there haven't been any problems.
>
> So does anyone have any information that I can show him (a reputable web link, perhaps) that says that Provigil and Parnate can be combined safely?
>
> He doesn't even want me combining coffee with Parnate, but if it weren't for the caffeine tabs I've been taking, I'd be asleep for much of the day (and as it is, I already sleep too much during the day as a result of the Parnate).
>
> The one positive thing I felt when I was on Desoxyn was that it completely eliminated all my daytime fatigue. I NEVER got tired while on it. So in that respect, it worked wonderfully. Unfortunately, it didn't do anything for my ADD-like symptoms--but then my diagnosis isn't really ADD, but something much more complicated and harder to treat - just my luck!! :-( .
>
> Any input would be much appreciated.
>
> thanks-
> Malcolm
poster:Tomatheus2
thread:761881
URL: http://www.dr-bob.org/babble/20070604/msgs/761893.html