Posted by SLS on August 1, 2009, at 14:14:14
In reply to Help here pls,esp. sls, posted by shasling on August 1, 2009, at 13:19:18
> I have been informed that my p-doc will no longer prescribe parnate for me,luckly Atogther i have close to six month supply,but i want to start fixing it now,tried calling and asking ahead of time if the doc there will use the maoi with me,thats not working,i dont know what to do/
>
> I was gonna add nortripyline (excuse spelling) as an augment agent,but now im wondering if i should try to slide it over as a primary ad kicking parnate out?
>
> SLS i know you do well on this combo so,
>
> 1 Are you still on parnate
> 2 Do you believe nortriplyine alone can be as potent
> 3what would you do in a case where you have to find a maoi using doc.
>
> Thanks ahead guys in advance.p.s although i dont want off parnate,i sure wouldent miss its horrid sleep insomnia.
How much Parnate are you taking, and how are you feeling now compared to how you would feel were you not to take any medication at all? Maybe the first step is to optimize the dosage of Parnate.If it were me, I would be cautious when adding the nortriptyline. You might want to start at 10mg and work your way up slowly to 75mg. After 1 week at 75mg, I would then get a blood test to see if you are taking enough. If you are a rapid metabolizer, you will need to take more. If getting this test is impossible, you might want to try 100mg. However, if you are not receiving any benefit, I would consider discontinuing the Parnate. After the 2 week washout, you can then add a SSRI/SNRI to the nortriptyline. My preferences are Effexor/Pristiq, Lexapro, and Zoloft.
Nortriptyline can be effective on its own, of course. However, you might as well try to optimize your chances of responding favorably.
If you need to shop for another doctor, ask the doctor or his secretary if he would use MAOIs.
Currently I am taking:
Parnate 80mg
nortripyline 150mg
Lamictal 200mg
Abilify 20mg
Lithium 600mg
- Scott
poster:SLS
thread:909676
URL: http://www.dr-bob.org/babble/20090801/msgs/909693.html