Posted by myco on March 11, 2009, at 15:36:03
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Im always interesting in the idea of augmenting meds to get better or different AD effects. To me this is the most interesting part of the study/use of Psychiatry.
Ive recently read a few studies focusing on the use of Clonidine (an old antihypertensive med that is being re-evaluated for other indications neuropathic pain, ADHD, Tourettes, and as a sleep aid yay!) to potentiate the AD effects of: MAOIs; TCAs; SSRIs, Atypical ADs; Stimulants and some non-AD meds.[1][2]
Clonidine may have effects on Norepinephrine and Seratonin (older studies state SE while Wiki only mentions NE) that are useful as an augmentation tool.
Interestingly, the authors dont focus on possibility of Serotonin syndrome which makes me think that perhaps Serotonin doesnt play a key role with the efficacy of Clonidine (somewhat old studies; Wiki states only NE effect for Clonidine with no mention of SE).
The 2 studies Ive looked at in detail, both well written and easy to grasp for noobs, do use the forced swim test with mice not really a good indication, in my opinion, of what may occur in humans but still lend evidence. The doses seem to be quite high for most of the meds tested but the dosage of Clonidine in all cases is very low (for additive effect) at 0.06mg/kg to 0.1mg/kg (if you weigh 76kg thats ~4.6 to 7.6mg of Clonidine an acceptably small dosage)
Among MAOIs the dosages [2] (used in mice anyway) were massive and I dont think can be extrapolated to human usage (i.e. 8mg/kg of Nardil to show significant effect! yikes). Interestingly though, Moclobemide may show good augmentation pairing with Lithium [2] (havent read the study the authors refer to yet though). Among TCAs and SSRIs [1] the dosages (combined with 0.1mg/kg Clonidine less than 8mg if you weigh 76mg) were again massive (for mice) and the human translation is questionable to me (i.e. human ~300mg Celexa, ~600mg Paxil! for 76kg of weight lol). In the ATYPICAL AD category [1] only Trazodone has a reasonable, to me, human dose (~38mg - ~150mg area with Clonidine). Another study mentions Bupropion potentiated well with Clonidine [1] (Ive yet to read the study they refer to). Stimulants were not at all convincing in combo with Clonidine [1].
Sodoes anyone here have any experience using Clonidine with any AD or non-AD type med with success as an augmentation tool?
Please share your experiences.
Thanks,Myco
1) Bourin et al. 1991. Clonidine as a sensitizing agent in the forced swimming test for revealing antidepressant activity. J Psychiatry Neursci. 16(4): 199-203. (FREE ONLINE - check pubmed)2) Bourin et al. 2002. Clonidine potentiates the effects of tranylcypromine, phenelzine and two analogues in the forced swimming test in mice. J Psychiatry Neursci. 27(3): 178-185. (FREE ONLINE - check pubmed)
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poster:myco
thread:884892
URL: http://www.dr-bob.org/babble/20090304/msgs/884892.html