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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by ace on February 11, 2004, at 19:26:44
Clonidine is said to potentiate the effects of MAOI drugs...
Clonidine has shown efficacy in OCD...
Any comments on the safety/efficacy of this combo is welcome
Any comments on Ace's "drug-switching" are not!
I am trying to research ALL possibilities available for me...
Ace.
Posted by Chairman_MAO on February 11, 2004, at 22:20:55
In reply to Nardil + Clonidine- comments?, posted by ace on February 11, 2004, at 19:26:44
It would be prudent to have your physician supervise this closely, as it could exacerbate any hypotension associated with the Nardil. Clonidine can also worsen depression, worsen sexual dysfunction from the Nardil, and probably has other untoward effects that I don't know about. Furthermore, a cursory search on my part uncovered one reference about clonidine + OCD without an abstract, and one showing that diphenhydramine (the control medication in the study) was more effective than clonidine, which didn't work at all.
This is the price paid when using an MAOI; you often can't use other drugs that might be beneficial. Noradrenaline isn't what you should worry about targeting in managing OCD anyway. It's serotonin, dopamine, and the opioid system as far as I'm aware (which might not be far enough).
Since you can't take carbamazepine on an MAOI (not 100% sure about this, but it's listed as a drug interaction), I would try lamotrigine or riluzole. These are documented as beneficial, and antiglutaminergic activity would help, not hurt, the effects of the Nardil.
If those don't work, IMHO, you'd do better trying a dopamine agonist before clonidine. Try ropinirole, it has some modest opioid activity, although I'm not sure if it is significant at therapeutic concentrations--maybe someone else here can help me out in that area.
Best of luck.
Posted by ace on February 11, 2004, at 23:22:15
In reply to Re: Nardil + Clonidine- comments? ?ace, posted by Chairman_MAO on February 11, 2004, at 22:20:55
> It would be prudent to have your physician supervise this closely, as it could exacerbate any hypotension associated with the Nardil.
I have NO hypotension at all with Nardil...
Clonidine can also worsen depression, worsen sexual dysfunction from the Nardil, and probably has other untoward effects that I don't know about. Furthermore, a cursory search on my part uncovered one reference about clonidine + OCD without an abstract,Saw that too! I also have plenty of anecdotes...it seems worth a go...
and one showing that diphenhydramine (the control medication in the study) was more effective than clonidine, which didn't work at all.
>
> This is the price paid when using an MAOI; you often can't use other drugs that might be beneficial.Right 100%...but Nardil rocks!
Noradrenaline isn't what you should worry about targeting in managing OCD anyway. It's serotonin, dopamine, and the opioid system as far as I'm aware (which might not be far enough).
>
> Since you can't take carbamazepine on an MAOI (not 100% sure about this, but it's listed as a drug interaction), I would try lamotrigine or riluzole. These are documented as beneficial, and antiglutaminergic activity would help, not hurt, the effects of the Nardil.
>
> If those don't work, IMHO, you'd do better trying a dopamine agonist before clonidine. Try ropinirole, it has some modest opioid activity, although I'm not sure if it is significant at therapeutic concentrations--maybe someone else here can help me out in that area.
>
> Best of luck.Whats your opinion of Pindolol....i took 7.5mg in one day before when i was on 90 Nardil and around a gram of Lithium....it caused depression then, but now I am not on the same cocktail...who knows?
Posted by Questionmark on February 13, 2004, at 0:24:30
In reply to Nardil + Clonidine- comments?, posted by ace on February 11, 2004, at 19:26:44
Yeah, i dunno man. If the sexual side effects of Nardil bother you anywhere near as much as they do with me, you wouldn't wanna mess with anything that was gonna/ could make that any worse. Plus it might make some of the anticholinergic side effects even worse as well (esp. peripherally i think). And i say screw that also.
Thirdly, clonidine is quite capable of causing/ worsening depression, esply. if taken chronically or at high enough doses. Personally i'd really suggest going with something else. Some of Chairman MAO's suggestions seem worthwhile. i'd really like to try Requip or another DA agonist with Nardil (at modest/safe doses of course), as i'm hoping it could help with the cognitive problems, the anorgasmia (especially!), and the slowness/ occasional drowsiness/ slight lack of motivation from Nardil (though let it be known i definitely have more motivation ON Nardil than when off and depressed out of my mind!). i want a DA agonist dangit. Anyway, sorry. Yeah maybe try one of his suggestions, or.. are you still on Zyprexa? Did that help? Maybe you should increase to 5mg or 7.5mg Zyprexa?? Not sure. Good luck man.
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