Posted by SLS on April 25, 2012, at 17:50:23
In reply to Re: i cant even smile. » SLS, posted by Alexei on April 25, 2012, at 17:34:17
> Of course, we now see how amphetamines can actually have a calming effect for some people.
>
> > - Scott
>
> Agree 100%. I could take my vyvanse at bedtime and fall out immediately.
>
>
> "Treating MDD with a combination of Parnate + desipramine can crack even the worst cases of depression"
>
> I've heard of this. Have you tried it? Suddenly it seems a waste of time to try anything else. IIRC, stims can be taken with MAOI if closely monitored.
The same is true of combining Parnate and desipramine. Traditionally, one either begins taking both drugs at the same time or establishes the desipramine first. Personlly, I have added desipramine to ongoing Parnate therapy without adverse effect. There is some indication that for TRD cases, the combination of Parnate and desipramine is more effective than either one alone. Because Parnate alone is capable of precipitating spontaneous hypertensive reactions, it is prudent to monitor blood pressure for the first few days when desipramine is added.http://apt.rcpsych.org/content/4/6/320.full.pdf
"Combining TCAs and MAOIs
The combination of TCAs and MAOIs has been in
use since the 1960s when the efficacy of this
regime was first strongly advocated. Although the
combination of MAOIs and TCAs is reported to be
hazardous, the risks of significant interaction can
be minimised if reasonable precautions are
taken. These include avoiding imipramine and
APT(1998),vol.4,p.324 Coiveti
clomipramine, and starting the drugs together at low
dose or adding the MAOI cautiously to established
TCA treatment (see Chalmers &Cowen, 1990).
In patients not selected for treatment resistance
the combination of MAOIs and TCAs does not
appear to confer additional therapeutic benefit over
either drug used alone. However, Sethna (1974)
carried out an open study of MAOI-TCA treatment
in 12 patients with depression who had failed to
respond to either TCAs or MAOIs given separately
(or electroconvulsive therapy (ECT) in 10 cases). At
follow-up periods of 7-24 months, nine subjects
were reported to be without significant depressive
symptomatology. Most of these subjects had chronic
non-melancholic depression with prominent
anxiety symptoms.
In addition to these series, case reports continue
to appear where it seems well documented that a
patient has failed to respond to either a TCA or an
MAOI given alone, but achieves a good clinical
response when both drugs are used together (Tyrer
& Murphy, 1990). Therefore, although controlled
evidence is lacking, it seems likely that individual
patients with refractory depression are helped by
MAOI-TCA combinations. Generally, the adverse
effects of the combination are no worse than with
either drug alone, although weight gain and
postural hypotension may be more troublesome.
Conversely, if an MAOI is given with a TCA such as
amitriptyline or trimipramine, MAOI-induced
insomnia may be prevented.
There is less information about the combination
of other antidepressants with MAOIs. However,
trazodone in doses of 50-150 mg is fairly commonly
used to treat MAOI-induced insomnia and is
generally well-tolerated (Nierenberg &Keck, 1989)."
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1016383
URL: http://www.dr-bob.org/babble/20120425/msgs/1016402.html