Posted by Astounder on November 16, 2007, at 8:36:14
In reply to Re: Shouldn't matter when you take it » Astounder, posted by tecknohed on November 16, 2007, at 4:50:58
> > Marplan like Parnate and Nardil is an unselective, irreversible inhibitor of MAO. Irreversible meaning it forms a covalent bond with enzyme, permenantly inactivating it. You have to wait weeks for your body to produce another enzyme. Since the orthostatic/postural issue is a direct effect of inhibiting MAO, you can't fix this by spacing the dose. The hypotension is mediated by increased uptake of octopamine, a trace amine like tyramine, into noradrenergic terminals. Normally this transmitter is kept at low levels, but if you start inhibiting MAO, the levels go up.
> >
> > What you could try doing is adding on a selective NRI, like desipramine. Not only will this increase noradrenaline levels, it'll prevent octopamine from entering the NA terminals. This also abolishes the pressor response to tyramine, so you can be less picky about what you eat.
>
> Not too sure about the dose spreading being uneffective. When I took Nardil I was fine when I woke up in the mornings, then after my first dose I'd be virtually blind with dizziness.
>
> Your right about an NRI blocking the tyramine effect. I know reboxetine has been studied well for this. But didn't you say that they "cause plastic NET downregulation after a few weeks, like all other NAergic antidepessants. An effect that remains after treatment ends." http://www.dr-bob.org/babble/20071115/msgs/795398.html
> So are they good or bad?
> I'm sure that if there is a way of getting around the low blood pressure effect without the use of more artificial drugs then that would be prefered?Less NET pumps = Less NE/tyramine/octopamine/DA uptake into NA terminals. This is similar to the action of tertiary amine tricyclics and SSRIs on SERT. It's probably responsible for the plastic, curative (not palliative) effects of antidepressants, why you can often remove the drug after remission and still maintain their effects. Opposite, drugs you develop tolerance to, like DAT blockers, increase the number of DAT pumps, making them less effective over time.
poster:Astounder
thread:794573
URL: http://www.dr-bob.org/babble/20071115/msgs/795443.html