Posted by SLS on August 27, 2016, at 13:55:17
In reply to Re: Started Nardil » SLS, posted by Escapee on August 27, 2016, at 11:09:56
I think it is a dangerous game to add any SSRI to phenelzine. My impression is that it will result in serotonin syndrome almost every time.
The 1 mg phenelzine/kg body weight serves pretty well. That leaves me at 90 mg/day, which just so happens to be optimal for me. 75 mg/day is too low, and increasing the doaage produces no further improvement. The formula is a guideline - nothing more. Some people will need more; others will need less. I have gone to 120 mg/day. You need to be careful with phenelzine, though. The ratio of dose/blood level is not linear. Phenelzine inhibits its own metabolism, so every 15 mg increase in dosage will produce a larger and larger increase in blood level. It is much easier to overdose on phenelzine than on tranylcypromine.
Because you have not taken phenelzine in so long, I don't think you can necessarily expect that it will not work well. In the past, some doctors would have their relapsing patients discontinue phenelzine for three or more months in order to recapture a response to it. One of my doctors had a patient switch back and forth between phenelzine and tranylcypromine once a relapse occurred for each one.
I think you can be cautiously optimistic.
- 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:1091031
URL: http://www.dr-bob.org/babble/20160819/msgs/1091569.html