Posted by SLS on May 17, 2019, at 11:15:30
In reply to Tranylcypromine - Fluctuating Effects, posted by TH on May 15, 2019, at 3:40:28
Your propositions are very logical.
Some researchers now suggest that one can have a bipolar diathesis (biological predisposition) without ever experiencing mania. Emil Kraeplin introduced the term "manic depression" as a diagnosis that included presentations that were unipolar. I experience mania only in association with taking MAOIs. It is probably significant that I was an ultra-rapid cycler for two years prior to treatment with antidepressants. I would oscillate between a severe depression lasting 8 days followed by a state approximating remission lasting 3 days. The cycle did not deviate. My cycling completely stopped upon the introduction of lithium. Thereafter, I was stuck in a state of unremitting depression, even after the lithium was discontinued.
In your situation, I would suggest that you consider adding low-dose lithium (300-600 mg/day) and/or lamotrigine to the Parnate. Adding Abilify is also something to consider. I have safely combined Parnate with desipramine, nortriptyline, and Wellbutrin.
The two reuptake inhibitors that I have had some success with are Effexor and Trintellix.
If you had some success with Wellbutrin, I would recommend combining it with a drug that inhibits the reuptake of serotonin - SSRI, SNRI, Viibryd, Trintellix, or perhaps clomipramine.
The simplest thing to do is to continue to increase the dosage of Parnate. Many people do respond to 40 mg/day, but some need to increase the dosage to between 60-80 mg/day. Are you prevented from doing this? What has been your experience with Nardil?
I hope you continue to post your experiences as you move forward.
- Scott
Some 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:1104415
URL: http://www.dr-bob.org/babble/20190513/msgs/1104440.html