Posted by desolationrower on April 6, 2009, at 8:48:43
In reply to Re: Augmenting Parnate w/ low dosage of Selegiline, posted by cellomoi on April 6, 2009, at 6:35:37
> Problem is, my psychiatrist will NOT go any higher at the moment. He is willing to augment it though, hesitant but willing to try. Since no one believes it is possible to augment parnate with selegiline. What should I suggest to him to use to augment the parnate?
>
> My primary issues at the moment are day-time tiredness, lack of motivation, and the frequent long-lasting depressive episode. Cognition is also a bit blunted.
>
> According to him, adding a psycho-stimulant is possible, and he is willing to try. But, he said it is a 50/50 chance. That is, 50% of people find it extremely beneficial, the other 50% have a hypertensive crisis. Does anyone know of any journal articles I can give him to read, to sort of change his mind?
>
> Also, when augmenting parnate, with say ritalin or adderall, what is the starting dosage? 2.5mg? 5mg? Same with a TCA, where does one start from, and which would be the best TCA to try?
>
> Thank Youhaha. my pdoc let me go as high with the parnate as i wanted (or, could afford at any rate), but nothing augmenting.
the 50/50 thing, who knows where he came up with that.
if $ isn't an obsticle, modafinal might be a good choice, since it won't have the risk of interaction, and could help with tiredness and the other symptoms, and is probably lower risk of triggering mania. otherwise, i suppose desipramine/reboxetine sine you still have depression, but not anxiety/insomnia stuff (i guess.).
i don't have any articles saved on that specifically (i mean, the evidence is quite clear. i'm interested in hard topics. i don'to have a good feel for what pdocs learn in residency. maybe i should try to find out.), i'd look on scholar.google.com com, for recent review articles. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2014120 has some stuff on tca interactions with MAOIs which would probably be a start.
the other thing is, what about your other medications? the abilify, do you think it is helping? i know when i took it, it sucked any remaining motivation out of me. maybe if you were on a different mood stabilizer or a lower dose of abilify you'd feel back to 100%.
-d/r
poster:desolationrower
thread:888874
URL: http://www.dr-bob.org/babble/20090330/msgs/888948.html