Posted by J Kelly on March 5, 2016, at 16:18:10
In reply to Re: Nardil safe? » J Kelly, posted by SLS on March 5, 2016, at 14:33:00
> When was Geodon first added relative to your discontinuation of Parnate?
Here's the timeline:
-Parnate started/titrated to 80mg
-Ritalin added/good response/ten day remission
-Ritalin replaced with Dexedrine
-Great response
-Parnate 80mg/Dexedrine 40mg
-Full remission/some mania (non psychotic)
-Psychosis (80mg parnate/2 weeks on 40mg Dexedrine)
-Dexedrine removed after 2 weeks
-Psychosis ongoing/Parnate cont'd for 9 months
-3rd hospitalization parnate removed/Geodon added
-2 weeks on Geodon/off parnate/psychosis ends
> > Still think I'm bi-polar I?
>
> I am still leaning in that direction. I am taking into consideration your description of your traveling. It really depends upon how you answered the question regarding the timing of Geodon administration.
>
> Have you ever tried Lamictal? If you think you are bipolar, I would consider adding Lamictal for the long term to help with your present depression and protect you from future depressions.I've never paid much attention to a diagnosis but I'm remembering my first pdoc speculated that I maybe was bi-polar 2. Not sure what that was based on but it was prior to my psychotic episode. I believe I tried Lamictal and Lithium. Its been long enough though that I'd be willing to try one or both again.
>
> IF Nardil doesn't work out, you might end up back on Parnate.No. Unfortunately Parnate is no longer an option. My family will not support that and after what I put them through I just can't go there.
>
> ----------------------------------
>
> One possible aggressive scenario:
>
> 1. Continue Zyprexa.
>
> 2. Begin Nardil on day 1 and titrate to 60-75 mg/day.
>
> 3. Begin Lamictal on day 1. It takes 6 weeks to reach a therapeutic dosage (200-300 mg/day) using a very gradual titration schedule. Screen for the emergence of a rash-reaction.
>
> 4. Add methylphenidate or amphetamine if necessary after being on Nardil 75 mg/day for 3-4 weeks.
>
> 5. Return to Parnate if necessary following a 14 day washout beginning from the last dose of Nardil.
>
> 6. Continue Lamictal.
>
> 7. Continue methylphenidate or amphetamine.
>
> 8. After you have been euthymic for an extended period of time, you might decide to discontinue the stimulant, Nardil, and Zyprexa - in that order.
>
> 9. Remain on Lamictal to prevent future relapses into depression.
>
> * This is meant to give you ideas. It might not end up being the exact protocol that you find yourself following.Other than the parnate, I like these ideas. I don't see my pdoc going for this however. He's pretty conservative. I'd have to find a new pdoc but I'm willing.
>
> ----------------------------------
>
> Hopefully, adding Nardil to Zyprexa will be sufficient. Simple is good. Take one day at a time. Make one decision at a time. Be patient.Wasn't it you who used to say "be a patient patient"? I know I picked that up here :)
> One time when I became manic on Nardil, adding Zyprexa worked within 12 hours and I did not feel at all slowed-down. Actually, Zyprexa gave me an increase in thought clarity. I wish that I had continued to feel that way.I'm curious. Were you aware of your manic state? Or did others call you out?
>
> What are your thoughts?See above!
>
>
> - ScottJade
poster:J Kelly
thread:1086626
URL: http://www.dr-bob.org/babble/20160131/msgs/1086763.html