Posted by MightyKondrian on July 24, 2018, at 14:37:44
In reply to Re: MAOI + ritalin, posted by linkadge on July 24, 2018, at 8:30:28
> 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-q10
>
>
>
> A 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 morning
>
> Linkadge
>
>
I'm well used to amitriptyline. The antihistamine effect has long gone in the morning.
(the reason I sleep so much is cos I dont wann face the world, not coz I'm overly tired.
I'm lucky if it puts me to sleep within the hr like it used to. I think 150mg amitriptyline might be worth a try, just for a week see what happens. Trimipramine gives me dreams that are far too lucid and usually disturbing.
I have lots of melatonin to try (backup). Mybe I should pop one at night and maybe I wont feel so doomed when I wake up. Get my sleep sorted.Tried PEA with MAOI before. Not for me.
I have l-tryptophan too. Aparently I'm to slowly work up from a small dose of 250mg up to 3g pm.
Each time I go from 3-4mg clonazepam I end up back on 4mg. I would rather add/exchange meds for supps once I'm more steady but thanks for all the suggestions.My doc said that back to pre-SSRIs the norm for stubborn depression was Nardil + lithium + L-tryptophan. An idea for the future.
From his point of view mostly only sedating TCAs should be combined with MAOIs. He's already said no to nortrptyline. I'm not to bothered about. He allows bupropion only coz I had a history of MAOI + bupropion before from a Prof of Neoro-psychiaty (well known). Guess that made him comfortable with it up to 450mg.
I already take a whole heap of supps inc activated b2,b6, b12 & folate. Plenty of D3. And high doses of most of the rest. I think I will up my vit C back to 3-5g daily. In fact they are tucked away so I keep forgetting they're there duh!
Another excellent nootropic oxiracetam + CDP coline is also tucked away forgot about. Out of site out of mind huh
I thank you for your post and I've saved it for future reference ;)
I'll keep this thread updated coz things are desperate now and If I find something that does the job I want you all to know about it!
I've also been thinking of an implant which my doc Dr Malizia pioneered & help design. It really is getting to that point :(https://www.bbc.co.uk/news/av/health-12285852/deep-brain-stimulation-hope-for-depression
Phenelzine 90mg, Amitriptyline 100mg, Clonazepam 3mg, Bupropion XL 300mg, Quetiapine XL 200mg, L-tryptophan 3g, Acamprosate 2g,
poster:MightyKondrian
thread:1099858
URL: http://www.dr-bob.org/babble/20180521/msgs/1099887.html