Posted by desolationrower on December 3, 2008, at 23:54:49
In reply to Re:BEST NARDIL AUGMENTATION?))d/r, posted by that_guy23 on December 2, 2008, at 19:42:22
You say that kpins worked really well in the past for you, increasing that might be an option? gabaergics are probably the best thing for anticipatory anxiety.
Since you have low blood pressure, and have been prone to addictive behavior, an NRI might be a good choice to augment. It might help more with the depression than a stimulant would, and reduces risk of tyramine problem. And not addictive/scheduled. It sounded like you tolerated nortryptiline well, but didn't get a sufficient dose; i also like nortriptyline as a drug since it is rather potent 5ht2 blocker. There is less case report of moai & bupropion, but i'd be interested in how that would work. i agree methylphenidate is probably easier than amp, but i think its a toss up if it would be better than just a pure nri - it might make stuff more natural, or it could make you feel more like people are focused on you. I don't think a mood stabilizer would be a good idea yet, you don't have any history of mania, no?Bechtenol is a cholinergic, i think it would be more helpful if it were a anticholinergic tca that were causing your sexual problems; its more likely the serotonergic nature. My sexual function gradually returned on parnate, but i'd think cyproheptadine is worth trying first, as its quite safe and cheap. And if it doesn't work, you can still use it as a sleep aid. The other main thing would be alpha1 agonism, unfortunatly most tcas are alpha1 antagonists even though they increse availible norepinepherin. And you can't use something like ephedrine. So this is part of why an nri or stimulant might help. Of course its hard to predict in teh context of an MAOI.
I think you have number of conventional options yet, just a matter of trying them. You only need medication that works well enough for the therapy and practice to start to make things easier, not harder. And i'd probably stick with the better known treatments, as there is less risk that way and doctors are more familiar with them. Reboxetine is nice if you can get it, desipramine is the cleanest of tcas, but nortrip has advantages especially if the maoi gives you some insomnia. there is attomoxetine too, but it doesn't seem so good. For methylphenidate, make sure to get a long-acting version. IF your doc is not willing for either option, modafinal could help, although it seems to be weaker for most people, i think it would help more in terms of energy than anxiety.
-d/r
poster:desolationrower
thread:863270
URL: http://www.dr-bob.org/babble/20081123/msgs/866572.html