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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 44. Go back in thread:
Posted by Judy on May 28, 2000, at 18:46:15
In reply to Re: Social Phobia: Nardil or Paxil ? - Judy again, posted by Judy on May 26, 2000, at 19:52:14
Scott -
Just wanted to make sure you saw my thread above. I forgot to put your name in the subject line.Judy
Posted by SLS on May 28, 2000, at 21:44:28
In reply to Re: Social Phobia: Nardil or Paxil ? - SLS, posted by Judy on May 28, 2000, at 18:46:15
> Scott -
>
> Just wanted to make sure you saw my thread above. I forgot to put your name in the subject line.
>
> Judy
Judy - I saw your post, read it, was thinking about it, got distracted, and then forgot about it. (cowering in shame) I am very sorry.Serotoninergic drugs don't seem to be helpful.
For now, I think you should continue with Parnate and take things one step at a time.
1. Increase the dosage to 80mg.
2. Go get that consultation in Boston - Andrew Nierenberg at Massachussetts General Hospital / Harvard.
3. Get a referral for a new doctor.
4. Get a new doctor if you are comfortable with this.
5. Keep your ears open for other suggestions.
6. Continue to have orgasms in the mean time.Possibilities:
1. Using the stimulant/dopaminergic drugs I listed in the previous post as adjuncts to Parnate.
- Ritalin
- Dexedrine
- Mirapex
2. Add low-dose lithium 300-600mg
3. Add thyroid.
4. Add a tricyclic
5. Add low-dose neuroleptic (Zyprexa, Risperdal, Seroquel)
6. Add amisulpride - I'm looking into this for myself.
Try making a list of all of the drugs that improved your depression - no matter how little, how long, and regardless of side effects.* Is there any history of mental illness in your family?
Sincerely,
Scott
Posted by Judy on May 29, 2000, at 9:29:10
In reply to Re: Social Phobia: Nardil or Paxil ? - SLS, posted by SLS on May 28, 2000, at 21:44:28
Scott,
Thank you very much for taking the time to respond. I've printed out your suggestions and will hang on to them to refer to.
>1. Increase the dosage to 80mg.
Obviously the easiest to try, and this is probably what I will do right away.
>2. Go get that consultation in Boston - Andrew Nierenberg at Massachussetts General Hospital / Harvard.
I know I need to make that trip into Boston. Thanks for the starting point.
>* Is there any history of mental illness in your family?
I honestly don't know. I'm an only child. Most of my relatives were much older than I so even if there were, I wasn't told about. I can, however, bet money on the fact that my late father suffered from depression, or at least dysthymia. The more I think back, the more I realize how many of the same symptoms he exhibited. He took Valium for as long as I can remember for the 'stress' of his job. He never hit the 'black hole' like I do however. Interestingly, maybe, is that I have one daughter with severe OCD and the other has just been diagnosed with ADD.
Again, thank you; and I hope amisulpride turns out to be the augmentation you've been looking for.
Judy
Posted by Peter S. on May 29, 2000, at 16:02:11
In reply to Re: Social Phobia: Nardil or Paxil ? - Judy again, posted by Judy on May 26, 2000, at 19:52:14
> It’s like a cruel joke, really. There is a med that makes me feel better than I’ve ever felt – and I can’t tolerate it physically. The edema set in at about 30 mg/day and was pretty severe at 45 mg/day (my maintenance dose). My feet and ankles were elephantine by the end of the day, and when I awoke in the morning, my face was swollen beyond recognition. To add insult to injury, Nardil made me almost dead from the waist down – I was barely able to urinate and my intestines basically shut down (I could go 7 days and not even feel any discomfort!) That ruled out the possibility of trying a diuretic to alleviate the edema since all the fluid would have ended up in my non-functioning bladder. I just couldn’t figure out a way to make Nardil work – there were too many strikes against me. Trust me, I will be the first person in line if and when the Nardil patch makes an appearance on any market in the world!
>Judy: I have been on Nardil for the last couple of months, and it seems to be the first drug that works on a semi-consistant level- although not as much as I'd like. I'd love to increase the doseage but right now I'm experiencing some of the same side effects that you talk about: not edema but major constipation which I have yet to figure out how to deal with. Next step is to try and guzzle as much mineral oil as I can tolerate. Have you heard of any other ways of dealing with this? Sexual side effects/anorgasmia are definitely present as well. I have heard that gingko biloba can be effective in treating sexual side effects; ever tried it?
> All the SSRI’s made me so fatigued that I couldn’t get up in the morning, couldn’t function for the rest of the day. No benefit at all no matter how much of a trial period I gave them.
I had exactly the same side effects (major fatigue) with all the SSRI's but I would get benefit for a couple of days every 1-2 weeks.
I have tried all the medications that you mention along with Moclobemide, amilsulpride and many others and found little benefit. I would love to make Nardil more tolerable (it's my last hope)- if I could just deal with the constipation! Anyway I appreciate hearing about your experiences and wish you the best of luck.Peter S.
Posted by Judy on May 29, 2000, at 20:04:02
In reply to Re: Nardil - Judy , posted by Peter S. on May 29, 2000, at 16:02:11
Hi Peter,
Sorry to hear that you're in the same boat. What a shame that Nardil works for us mentally and then does us in physically, huh?
> I'd love to increase the dosage but right now I'm experiencing some of the same side effects that you talk about...
How much Nardil are you taking now? I suspect once you hit the side effects plateau, they don't get any get any worse (how could they?), but you might see increased AD benefits at higher doses.
>...major constipation which I have yet to figure out how to deal with. Next step is to try and guzzle as much mineral oil as I can tolerate. Have you heard of any other ways of dealing with this?
I couldn't beat it. The mineral oil might be worth a shot - I never even thought to try that! Increased dietary fiber, Metamucil, stool softeners did nothing to help. Enemas work pretty well (and in some circles they're even considered erotic! I don't happen to travel in those particular circles, nor did I have the time to spend when I had to be out of the house at 7 AM - but sometimes you do what you have to do!)
>Sexual side effects/anorgasmia are definitely present as well. I have heard that gingko biloba can be effective in treating sexual side effects; ever tried it?
I had complete and total anorgasmia with Nardil. Like I said - dead from the waist down in all departments. Unfortunately I still had a libido. Another of life's cruel little jokes. I tried Gingko and it merely seemed to increase my postural hypotension. I also tried an antihistimine (the name of which escapes me at the moment) and it just made me tired. I recently tried Viagra - nothing. But that's me - maybe one of them will work for you. Don't ever pass on a possibility based on somebody else's experience.
I assume you've tried Parnate? I've been taking it for several months now and, while it's not Nardil, it's probably the closest I've come. On the plus side, it has very few nasty side effects. Even the anorgasmia is not total - it just takes a loooooong time to get there. I'm planning to increase my dose from 60 mg to 70 or 80 - maybe the side effects are lying in wait there. I won't know until I try.
Good luck, Peter. Let me know if I missed something or you have any more questions.
Judy
Posted by AndrewB on May 30, 2000, at 3:42:10
In reply to Re: Nardil - Judy , posted by Peter S. on May 29, 2000, at 16:02:11
Peter,
Glad to hear that you have had a response to Nardil.
If you don't mind me asking, can you tell me your diagnosis and in what specific ways Nardil has improved your condition.
Also will you please give me any details you can about your amisulpride experience. I am trying to track peoples' responses.
The constipation combined with sexual side effects you describe reminds me of the side effects sometimes seen with certain antidepressants that act on norepinephrine such as reboxetine and some tricyclics. Nardil also acts on NE through its MAO inhibition. Nardil has a complicated action, one which I don't understand. Therefore it isn't for me to say that the constipation and sexual dysfunction is NE related, but it is only my point to suggest it as a one likely cause.
More specifically, it may be agonism of the alpha 2 receptor that is causing your constipation. The side effects of alpha 2 agonist drugs (used for hypertension) include constipation, drowsiness, sedation, dizziness,and hypotension.
This suggests a potential remedy for your condition, an alpha 2 selective agonist. Yohimbine is one such drug. Yohimbine, may people know, can be very effective in assisting some to overcome sexual dysfunction. When you take it, onset of action will take about 2 hours and effects can last for 24 hours. Side effects of yohimbine for many include agitation, insomnia, and a rise in blood pressure. Of course, if you are feeling sluggish, you may welcome these side effects. I would be very interested to know, if you try yohimbine, if it doesn't take away your constipation also.
Yohimex is a prescription medicine that is made of purified yohimbine. It is economical and has less side effects than yohimbine bark. You may want to talk to your psych. about the appropriateness of Yohimex (or another alpha 2 antagonist?) for your condition.
Bethanechol has also been noted to reverse sexual dysfunction of norandrenergic origen.
AndrewB
Posted by Peter S. on May 30, 2000, at 13:22:30
In reply to Re: Nardil - Peter S, posted by Judy on May 29, 2000, at 20:04:02
Hey Judy
> How much Nardil are you taking now? I suspect once you hit the side effects plateau, they don't get any get any worse (how could they?), but you might see increased AD benefits at higher doses.I'm taking 52.5 mg per day and I'd like to get up to 60. As to the constipation; mineral oil doesn't seem to do anything and as you say neither does increasing fiber in the diet. I think what has happened is that the old intestine is just not really doing anything. So I think the way to go is laxatives, which seem to work to some extent. I hate the idea of getting addicted to laxatives though.
? I've been taking it for several months now and, while it's not Nardil, it's probably the closest I've come. On the plus side, it has very few nasty side effects. Even the anorgasmia is not total - it just takes a loooooong time to get there. I'm planning to increase my dose from 60 mg to 70 or 80 - maybe the side effects are lying in wait there. I won't know until I try.
>Yeah I was on Parnate for almost a year and I couldn't get above a certain dose again because of constipation. I also found other side effects unpleasant; like the speedy morning and then the poop out in the afternoon. I also noticed that it affected my sense of taste; weird huh?
But I hope Parnate works for you; sounds like we are both on similar trails.
Good luck,
Peter
Posted by Peter S. on May 30, 2000, at 13:31:09
In reply to Re: Peter S , posted by AndrewB on May 30, 2000, at 3:42:10
> Peter,
>
> If you don't mind me asking, can you tell me your diagnosis and in what specific ways Nardil has improved your condition.Diagnosis is probably dysthymia for most of my life with a healthy dose of social phobia mixed in.
> Also will you please give me any details you can about your amisulpride experience. I am trying to track peoples' responses.
My experience with amisulpride was that I noticed and increase in sleepiness but this was bearable. Other side effects were minimal. However I noticed no therapeutic effects and I think I gave it about a 3-4 week trial.
>
> The constipation combined with sexual side effects you describe reminds me of the side effects sometimes seen with certain antidepressants that act on norepinephrine such as reboxetine and some tricyclics. Nardil also acts on NE through its MAO inhibition. Nardil has a complicated action, one which I don't understand. Therefore it isn't for me to say that the constipation and sexual dysfunction is NE related, but it is only my point to suggest it as a one likely cause.
>
> More specifically, it may be agonism of the alpha 2 receptor that is causing your constipation. The side effects of alpha 2 agonist drugs (used for hypertension) include constipation, drowsiness, sedation, dizziness,and hypotension.
>
> This suggests a potential remedy for your condition, an alpha 2 selective agonist. Yohimbine is one such drug. Yohimbine, may people know, can be very effective in assisting some to overcome sexual dysfunction. When you take it, onset of action will take about 2 hours and effects can last for 24 hours. Side effects of yohimbine for many include agitation, insomnia, and a rise in blood pressure. Of course, if you are feeling sluggish, you may welcome these side effects. I would be very interested to know, if you try yohimbine, if it doesn't take away your constipation also.
>
> Yohimex is a prescription medicine that is made of purified yohimbine. It is economical and has less side effects than yohimbine bark. You may want to talk to your psych. about the appropriateness of Yohimex (or another alpha 2 antagonist?) for your condition.
>
> Bethanechol has also been noted to reverse sexual dysfunction of norandrenergic origen.
Thanks a lot for the information and ideas! I will definitely show this to my pdoc and see what he thinks about it.I'd be interested in hearing the results of your amisulpride poll. Take care.
Peter
Posted by AndrewB on May 30, 2000, at 22:07:51
In reply to Re: Andrew, posted by Peter S. on May 30, 2000, at 13:31:09
Peter,
Thank you for your response. Please give us a follow up after awhile on how you are doing with Nardil. Your results are encouraging.
A couple of more questions:
1) In what specific ways has Nardil improved your condition.
2) What dosag(es) did you use for your amisulpride trial.
Thank you,
AndrewB
Posted by Peter S. on June 2, 2000, at 1:56:31
In reply to Re: Peter, follow up Qs, posted by AndrewB on May 30, 2000, at 22:07:51
>
> 1) In what specific ways has Nardil improved your condition.Hi Andrew;
My depression is definitely reduced and I am feeling much more social in general. I'd still like to increase the dose up to 60mg if possible. Right now it seems a bit early to see or report major changes in my life/relationships. I have had so many experiences where a med would work briefly and then would stop working that I am very gunshy. If this lasts or improves for another couple months I will be able to report more.
>
> 2) What dosag(es) did you use for your amisulpride trial.I'm pretty sure I used the recommended dose of 1/4 of a pill. I don't remember exactly the amount. I could go back into my records and check.
Hope this helps.
Peter S..
Posted by michael on June 2, 2000, at 2:12:50
In reply to Re: Peter, follow up Qs, posted by Peter S. on June 2, 2000, at 1:56:31
Hey Peter -
I don't mean to be difficult, but do you know what the dose was in terms of mg? Are you referring to 1/4 of a 50mg tablet, or 1/4 of a 200mg tablet - the second of which would get you down to the 50mg dose?
I'm also curious, because the 50mg/day dose had me sleeping a minimum of 12 hours... However, from what I've read, that's a response more typical of high doses... Just curious.
> >
> > 1) In what specific ways has Nardil improved your condition.
>
> Hi Andrew;
>
> My depression is definitely reduced and I am feeling much more social in general. I'd still like to increase the dose up to 60mg if possible. Right now it seems a bit early to see or report major changes in my life/relationships. I have had so many experiences where a med would work briefly and then would stop working that I am very gunshy. If this lasts or improves for another couple months I will be able to report more.
> >
> > 2) What dosag(es) did you use for your amisulpride trial.
>
> I'm pretty sure I used the recommended dose of 1/4 of a pill. I don't remember exactly the amount. I could go back into my records and check.
>
> Hope this helps.
>
> Peter S..
Posted by Peter S. on June 2, 2000, at 20:14:01
In reply to Re: Peter, follow up Qs » Peter S., posted by michael on June 2, 2000, at 2:12:50
Hi Michael
> I don't mean to be difficult, but do you know what the dose was in terms of mg? Are you referring to 1/4 of a 50mg tablet, or 1/4 of a 200mg tablet - the second of which would get you down to the 50mg dose?
Yes after checking my notes, it was 1/4 of a 200mg tablet, or 50mg.
> I'm also curious, because the 50mg/day dose had me sleeping a minimum of 12 hours... However, from what I've read, that's a response more typical of high doses... Just curious.
I also noticed an increase in sleep which wasn't unbearable. The issue or why I stopped (after 9 weeks) was a complete lack of therapeutic response.
Peter
> > > 1) In what specific ways has Nardil improved your condition.
> >
> > Hi Andrew;
> >
> > My depression is definitely reduced and I am feeling much more social in general. I'd still like to increase the dose up to 60mg if possible. Right now it seems a bit early to see or report major changes in my life/relationships. I have had so many experiences where a med would work briefly and then would stop working that I am very gunshy. If this lasts or improves for another couple months I will be able to report more.
> > >
> > > 2) What dosag(es) did you use for your amisulpride trial.
> >
> > I'm pretty sure I used the recommended dose of 1/4 of a pill. I don't remember exactly the amount. I could go back into my records and check.
> >
> > Hope this helps.
> >
> > Peter S..
Posted by AndrewB on June 3, 2000, at 8:46:29
In reply to Re: Michael, follow up Qs, posted by Peter S. on June 2, 2000, at 20:14:01
Peter,
Your diagnosis of dysthymia and social phobia indicates dopaminergic D2-3 hypofunction. A recent study indicated low D2 receptor binding potentials in social phobia. Nardil has long thought to be effective for social phobia due to its dopaminergic action. Therefore one would think that the D2-3 dapaminergic activity enhancing amisulpride would be a drug that you would be responsive to. But this obviously wasn't the case. All you experienced was sleepiness. Michael experienced the same thing at 50mg. Sleepiness indicates that one is taking too much amisulpride and the postsynaptic, rather than the targeted presynaptic D2-3 receptors, are being stimulated. Intuitively the solution would be to lower the dose. Michael has done this, lowered his dose to 12.5 mgs., with some initially promising results. You may therfore wish to retry amisulpride at a lower dose (such as 25mgs) as an augmenting agent to nardil. Let me know if you find this effective. Indeed, if you are able to find effective dopaminergic augmenting agents for Nardil (like amisulpride), you should be able to lower the effective dose of nardil and thus lower your side effects.
Posted by SLS on June 3, 2000, at 9:37:20
In reply to Re: Amisulpride, Peter S, posted by AndrewB on June 3, 2000, at 8:46:29
Dear Fellow Sufferers,
I am confused here.Who is currently taking Nardil + amisulpride in combination?
Is there a trend towards amisulpride producing sleepiness or sedation when it is added to Nardil?
Is anyone combining amisulpride with Parnate?
Thanks.
- Scott
------------------------------------
> Peter,
>
> Your diagnosis of dysthymia and social phobia indicates dopaminergic D2-3 hypofunction. A recent study indicated low D2 receptor binding potentials in social phobia. Nardil has long thought to be effective for social phobia due to its dopaminergic action. Therefore one would think that the D2-3 dapaminergic activity enhancing amisulpride would be a drug that you would be responsive to. But this obviously wasn't the case. All you experienced was sleepiness. Michael experienced the same thing at 50mg. Sleepiness indicates that one is taking too much amisulpride and the postsynaptic, rather than the targeted presynaptic D2-3 receptors, are being stimulated. Intuitively the solution would be to lower the dose. Michael has done this, lowered his dose to 12.5 mgs., with some initially promising results. You may therfore wish to retry amisulpride at a lower dose (such as 25mgs) as an augmenting agent to nardil. Let me know if you find this effective. Indeed, if you are able to find effective dopaminergic augmenting agents for Nardil (like amisulpride), you should be able to lower the effective dose of nardil and thus lower your side effects.
Posted by Seamus2 on June 3, 2000, at 9:56:42
In reply to Who is taking Amisulpride + Nardil or Parnate ? » AndrewB, posted by SLS on June 3, 2000, at 9:37:20
Scott,
I'll be giving the Parnate a two week washout, then trying the amisulpride. It gets but a two week shot itself, then I'll add the Parnate again.
Will let you know.
Seamus
> Dear Fellow Sufferers,
>
>
> I am confused here.
>
> Who is currently taking Nardil + amisulpride in combination?
>
> Is there a trend towards amisulpride producing sleepiness or sedation when it is added to Nardil?
>
> Is anyone combining amisulpride with Parnate?
>
> Thanks.
>
>
> - Scott
>
Posted by Peter S. on June 3, 2000, at 12:06:56
In reply to Re: Amisulpride, Peter S, posted by AndrewB on June 3, 2000, at 8:46:29
Andrew:
Thanks for the information and advice. I have never heard of amisulpride being used with a MAOI but admittedly I've never done any research in the area. Has any research been done that demonstrates the safety and effectiveness of doing this? I'm going to check Medline and see what I come up with. I'm curious to see how Seamus does with it. Anyway thanks again.
Peter
> Peter,
>
> Your diagnosis of dysthymia and social phobia indicates dopaminergic D2-3 hypofunction. A recent study indicated low D2 receptor binding potentials in social phobia. Nardil has long thought to be effective for social phobia due to its dopaminergic action. Therefore one would think that the D2-3 dapaminergic activity enhancing amisulpride would be a drug that you would be responsive to. But this obviously wasn't the case. All you experienced was sleepiness. Michael experienced the same thing at 50mg. Sleepiness indicates that one is taking too much amisulpride and the postsynaptic, rather than the targeted presynaptic D2-3 receptors, are being stimulated. Intuitively the solution would be to lower the dose. Michael has done this, lowered his dose to 12.5 mgs., with some initially promising results. You may therfore wish to retry amisulpride at a lower dose (such as 25mgs) as an augmenting agent to nardil. Let me know if you find this effective. Indeed, if you are able to find effective dopaminergic augmenting agents for Nardil (like amisulpride), you should be able to lower the effective dose of nardil and thus lower your side effects.
Posted by AndrewB on June 5, 2000, at 18:31:55
In reply to Re: Amisulpride, Andrew, posted by Peter S. on June 3, 2000, at 12:06:56
> Andrew:
>
> Thanks for the information and advice. I have never heard of amisulpride being used with a MAOI but admittedly I've never done any research in the area. Has any research been done that demonstrates the safety and effectiveness of doing this? I'm going to check Medline and see what I come up with. I'm curious to see how Seamus does with it. Anyway thanks again.
>
Peter,Can amisulpride be combined with an MAOI? That is an important question. I think I can get an answer but give me some time. Keep checking back.
AndrewB
Posted by michael on June 5, 2000, at 18:54:06
In reply to Re: Amisulpride, Andrew, posted by AndrewB on June 5, 2000, at 18:31:55
This is not entirely, but at least in part, the same question as amisulpride & selegiline thread was addressing. As I think I mentioned, I was wondering about that combo specifically, because both of these meds target the dopamine system.
I was referring to only 10mg selegiline daily, which, at this low dosage, preferentially inhibits MAOI-B. (MAOI-B the one that is supposed to break down dopamine). I've decided to give it a try, however, I am also taking a lower than usual dose of amisulpride - only approx. 12.5mg per day - just a quarter of a 50mg tablet (due to the fact that 50mg/day had me sleeping at least 12 hours/day).
Btw, tried going up to 25mg amisulpride/day, and was tired and lethargic & apathetic... not good. Don't know if that would've been the case w/o the selegiline. I had been taking the selegiline for about 10 - 14 days at the time, and the amisulpride for about 4 - 8 days when I tried the 25mg dose. Sorry, I guess I should've been making notes...
I don't have anything to contribute about other maoi's...
> > Andrew:
> >
> > Thanks for the information and advice. I have never heard of amisulpride being used with a MAOI but admittedly I've never done any research in the area. Has any research been done that demonstrates the safety and effectiveness of doing this? I'm going to check Medline and see what I come up with. I'm curious to see how Seamus does with it. Anyway thanks again.
> >
> Peter,
>
> Can amisulpride be combined with an MAOI? That is an important question. I think I can get an answer but give me some time. Keep checking back.
>
> AndrewB
Posted by AndrewB on June 5, 2000, at 23:47:44
In reply to Re: Amisulpride MAOI, posted by michael on June 5, 2000, at 18:54:06
Thanks for the new info. on your amisulpride experience.Recently read a study abstract that indicates 5mg. of selegiline does the same as 10mg.
Have you noticed any improvement on your seligiline, amisulpride combo.
I've had nice results with entacapone as a dopaminergic agent of arousal. I want to wait until I get a chance to combine it with Sinemet before I say anything more about it though.
AndrewB
Posted by SLS on June 6, 2000, at 7:54:58
In reply to Re: Amisulpride, Selegiline- Michael, posted by AndrewB on June 5, 2000, at 23:47:44
> I've had nice results with entacapone as a dopaminergic agent of arousal. I want to wait until I get a chance to combine it with Sinemet before I say anything more about it though.
This is very encouraging, Andrew. How would you describe "arousal"? What dosage are you currently taking, and what is the highest dosage you would consider trying?
- Scott
Posted by michael on June 6, 2000, at 10:15:39
In reply to Re: Amisulpride, Selegiline- Michael, posted by AndrewB on June 5, 2000, at 23:47:44
I can't say that I've noticed much of a difference - but as I mentioned, I started the selegiline pretty quickly after the amisulpride... too close to differentiate?
I'm thinking of trying stopping the amisulpride some time for a week or two, to try to better determine specifically what difference it makes...
Btw, I was kind of surprised by JohnL's comments on the negative sexual effects of the amisulpride. One of the reasons I wanted to try it again at the low dose, was that selegiline supposedly had positive effects in that arena - my thinking being that low doses of each med works to increase the dopamine...? And I don't have any problems w/that at the moment...?
> Thanks for the new info. on your amisulpride experience.
>
> Recently read a study abstract that indicates 5mg. of selegiline does the same as 10mg.
>
> Have you noticed any improvement on your seligiline, amisulpride combo.
>
> I've had nice results with entacapone as a dopaminergic agent of arousal. I want to wait until I get a chance to combine it with Sinemet before I say anything more about it though.
>
> AndrewB
Posted by Ant-Rock on June 6, 2000, at 10:47:10
In reply to Re: Amisulpride, Andrew, posted by AndrewB on June 5, 2000, at 18:31:55
> > Andrew:
> >
> > Thanks for the information and advice. I have never heard of amisulpride being used with a MAOI but admittedly I've never done any research in the area. Has any research been done that demonstrates the safety and effectiveness of doing this? I'm going to check Medline and see what I come up with. I'm curious to see how Seamus does with it. Anyway thanks again.
> >
> Peter,
>
> Can amisulpride be combined with an MAOI? That is an important question. I think I can get an answer but give me some time. Keep checking back.
>
> AndrewB
Hello everyone,
I am currently taking 40mg Parnate, 25mg Amisulpride, and between 20-30mg Ritalin/day. I just added the amisulpride to the mix yesterday in hopes of giving me back some sex drive. My first trial of amisulpride @50mg and eventually 100mg didn't have any effect, but this was done without the Parnate. If there are any surprises(good or bad)with this combo I will let you know.Best wishes to all,
Anthony
Posted by SLS on June 6, 2000, at 14:52:55
In reply to Re: Amisulpride, Andrew and all, posted by Ant-Rock on June 6, 2000, at 10:47:10
> Hello everyone,
> I am currently taking 40mg Parnate, 25mg Amisulpride, and between 20-30mg Ritalin/day. I just added the amisulpride to the mix yesterday in hopes of giving me back some sex drive. My first trial of amisulpride @50mg and eventually 100mg didn't have any effect, but this was done without the Parnate. If there are any surprises(good or bad)with this combo I will let you know.
>
> Best wishes to all,
> Anthony
Anthony - Thank you very much for this post. Parnate + amisulpride is one of the combinations I asked my doctor to look into. Now I can tell him that I have a guinea pig.GOOD LUCK !!!
By the way, why are you taking Ritalin, and how have you benefited from it?
Is your lack of sex-drive simply a feature of depression, or is it being caused by medication? Does Parnate + Ritalin completely take care of your depression?
Are you bipolar? How would you describe your depressed state? Which drugs have you benefited from in the past.
Sorry about all of the questions.
Thanks again.
- Scott
Posted by Ant-Rock on June 6, 2000, at 17:57:56
In reply to Re: Amisulpride, Andrew and all » Ant-Rock, posted by SLS on June 6, 2000, at 14:52:55
> > Hello everyone,
> > I am currently taking 40mg Parnate, 25mg Amisulpride, and between 20-30mg Ritalin/day. I just added the amisulpride to the mix yesterday in hopes of giving me back some sex drive. My first trial of amisulpride @50mg and eventually 100mg didn't have any effect, but this was done without the Parnate. If there are any surprises(good or bad)with this combo I will let you know.
> >
> > Best wishes to all,
> > Anthony
>
>
> Anthony - Thank you very much for this post. Parnate + amisulpride is one of the combinations I asked my doctor to look into. Now I can tell him that I have a guinea pig.
>
> GOOD LUCK !!!
>
> By the way, why are you taking Ritalin, and how have you benefited from it?
>
> Is your lack of sex-drive simply a feature of depression, or is it being caused by medication? Does Parnate + Ritalin completely take care of your depression?
>
> Are you bipolar? How would you describe your depressed state? Which drugs have you benefited from in the past.
>
> Sorry about all of the questions.
>
> Thanks again.
>
>
> - Scott
No Scott, I am not bipolar. My loss of libido has been with me ever since I had a severe traumatic reaction to a drug called Amoxapine. This med I was trying while being treated for a dysthymic depression/fatigue, sent my mind and body into a severe tailspin. I could go on describing all the problems this reaction left me with such as weakness and severe anhedonia, but it's just to sad to think about for very long. I've tried to get answers(God knows)but I've come up empty time and again.
I'm taking ritalin to augment the parnate, after reading about many successes this combo has had for extremely treatment resistant patients. I've read about grand remissions from this combo in DR. Bobs tips section(keywords: stimulants,maois)that several Doctors spoke of.
I've been on parnate before with decent results, hoping to increase dosage from 40mg soon. So far this combo hasn't been spectacular, but I'm still on a relatively low dose parnate, but it's at least given me the energy to get up and function in the morning. 2 weeks ago I was pretty much a vegetable, so I guess I should be thankful. Unfortunately the anhedonia is still prevalent.
Drugs that helped me in the past?
-Parnate somewhat
-Amineptine in some ways
-rTMS(transcr.magnetic-stim),subtle,very transient
-Ritalin after about my first week(only 10mg/day) I noticed much improved mood and anhedonia started to lift, I actually wanted to do things, but these short lived improvements began to wane and even upon increasing the dose it hasn't returned.
The components of my depression have always been the atypical kind. Slowed mental & physical fuction, fatigue, tiredness, lack of sex drive, apathy and so on. I've never had severe anxieties,panic, or mania.
Hope I could be of some help Scott, feel free to comment or ask anything, I certainly don't mind the questions and I always appreciate the input I get hear as well.
Anthony
Posted by michael on June 6, 2000, at 20:21:00
In reply to Re: Amisulpride, Selegiline- Michael, posted by AndrewB on June 5, 2000, at 23:47:44
Hey Andrew -
I did a bit or reading on the meds you mentioned... I had been wondering about levodopa as a possibility. Sounds interesting, if dopamine's the issue... Good Luck! I'll be looking forward to your "report".
The only other thing I would say is to be careful... Too much of a good thing (dopamine, in this case) might not be a good thing.
Isn't that (too much dopamine) what neuroleptics - like higher-dose amisulpride, etc. - are trying to address? Might psychotic symptoms be a side effect if carried beyond a certain point?
I've been wondering about that myself, since I've been experimenting w/low-dose amisulpride and selegiline...
One last Q for you... have you come across much/any rsch that specifically looks at dopamine (and its manipulation) as a focus in the treatment of depression/dysthymia? I haven't looked as of yet... Serotonin seems to get the lion's share of media attention... just curious. michael
> Thanks for the new info. on your amisulpride experience.
>
> Recently read a study abstract that indicates 5mg. of selegiline does the same as 10mg.
>
> Have you noticed any improvement on your seligiline, amisulpride combo.
>
> I've had nice results with entacapone as a dopaminergic agent of arousal. I want to wait until I get a chance to combine it with Sinemet before I say anything more about it though.
>
> AndrewB
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