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Re: Best med for complex-PTSD?

Posted by undopaminergic on February 19, 2020, at 14:05:55

In reply to Re: Best med for complex-PTSD?, posted by SLS on February 19, 2020, at 13:26:39

> Hi UD.


> > How high have you gone with the Parnate? Have you tried stimulant augmentation?
> Up to Parnate 120 mg/day + desipramine 300 mg/day.

That sounds adequate to me. At that dose, the MAO inhibition would be close to 100%.

I suppose you haven't tried a COMT-inhibitor? Think tolcapone (ie. not entacapone) is the only clinically available COMT-inhibitor to cross the blood-brain-barrier. It has been associated with liver toxicity however, so I suppose you need to monitor liver function if you use it.

> > Does acute amphetamine provide a boost for you at all?
> None.

Even with MAOIs?

> I actually get more of an energy kick from caffeine.

In my experience, a cocaine-like stimulant (like methylphenidate) works synergistically with caffeine. I'm generally speaking of caffeine doses between 500 and 1500 mg.

> > Stimulants reliably obliterate my apathy (amotivation) and sucidal ideation.
> That's great. What keeps you from using stimulants on a regular basis?

I have indeed done so, during several periods of time. There are a few reasons I am not doing it now. a) the stimulants lost a lot of their effect, b) I'm seeking a lasting cure through psychological interventions, and c) current hospitalisation. Also, I don't have suicidal ideation at present.





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