Posted by linkadge on July 24, 2018, at 8:30:28
In reply to Re: MAOI + ritalin » linkadge, posted by MightyKondrian on July 23, 2018, at 18:32:47
Amitriptyline could cause more oversleeping than other TCAs (more antihistamine effect).
Not sure what to recomend. Have you tried nortriptyline? (would be less sedating than amitriptyline). Trimipramine may produce deeper sleep than amitriptyline.
The problem with sedating antidepressants is that they can induce sleep, but often not restorative sleep. Amitriptyline and clonazepam could both do this to some extent. The upper / downer combos can take their toll.
Nardil can (unfortunately) also mess up sleep (reduce deep / REM sleep), leading to fatigue. You may notice that lower doses of nardil help relieve the somnolence.
You are on a lot of meds. Sometimes for TRD, more is not necessarily better. Also, when I have bouts of deep fatigue, sometimes supplements help a bit better with that. Here are a couple of supplements that may help depression and fatigue:
methylfolate (activated folic acid), methlycobalamine (activated b12)
niacin
vitamin d
phenylethylamine (PEA) (start very low with maoi)
tyrosine (start very low with an maoi)
co-q10A couple of suggestions:
Reduce the nardil
Switch amitriptyline to trimipramine or cyproheptadine + melatonin 1mg
Lower clonazepam a bit (add niacin + magnesium)
Vitamin d, b12, folic acid, q10 in morning
Tyrosine (start LOW) in morning)
Coffee in morning (if agrees with you)
Ritalin / Wellbutrin in morningLinkadge
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poster:linkadge
thread:1099858
URL: http://www.dr-bob.org/babble/20180521/msgs/1099878.html