Posted by tensor on February 16, 2014, at 4:59:19
In reply to Re: SLS » tensor, posted by SLS on February 15, 2014, at 16:17:59
> Actually, my suicidal reaction to reboxetine occurred in the absence of a MAOI. I don't recall if I was taking any other drugs at the time.
Okay, I'm sorry to hear you had such a bad reaction.
> > I'm trying to reduce daytime fatigue and I was thinking of adding a small dose of reboxetine in the morning.
>
> I've been using Focalin (dexmethyphenidate) to use as a PRN for difficult days. One can add it to a MAOI safely.Interesting, I have seen suggestions that if you add a stimulant you should start with a small dose and titrate, how does it work when you take it PRN? How large dose do you take?
My concern with adding stims is increased anxiety, but there are drawbacks with every option. Bupropion is also an option, but there is not much information on this combination.> I don't see how nortriptyline would represent a greater risk than reboxetine when added to Parnate. Supposedly, one should add the MAOI to ongoing TCA treatment. I don't understand the rationale for this, though. I have not seen any evidence to support this notion. I have added TCA to ongoing MAOI treatment a number of times.
I don't understand it either, as with much of the information regarding MAOIs, it can be a myth and/or based on outdated/incomplete data. Everything is deemed unsafe unless there is a clinical study that confirms its safety (as it should).
> I don't know what to make of agomelatine. I have seen it reduce rapid-cycling in bipolar 2 disorder. It had no therapeutic effect for me, but I was not taking a MAOI at the time. Perhaps the melatonin M1 an M2 receptor stimulation helps to regulate biological clocks. For depression, my guess is that the 5-HT2c antagonism participates in producing a treatment response.
I have no experience of it, if 5HT2C disinhibits NE and DA it could combat tiredness, but it's a long shot. It could be great for sleep.
> Thanks. I have had a difficult few days, both biologically and emotionally. Latuda made me feel significantly worse upon continued treatment and dosage increases, and I have run out of ideas for pharmacotherapy. Perhaps TMS is the next step. I am not feeling terribly optimistic.
>
> - Scott
>I'm sorry to read this, Scott. You're one of the few guys that have the know-how and courage to try combinations no one else has, making new treatments a viable option for others.
There is also Deep TMS, but I'm not sure how far they have come. Have you tried NMDA antagonists?/tensor
poster:tensor
thread:1060700
URL: http://www.dr-bob.org/babble/20140214/msgs/1060746.html