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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Chairman_MAO on March 3, 2006, at 13:07:30
Has anyone here stopped an SSRI drug with a 24-hour halflife or less and started an MAOI in less than two weeks? Is 72 hours enough? If I do not get out of this hole soon I am not going to be able to continue supporting myself and will have to go back to my parents' house. They do not understand me whatsoever and will only do whatever it is contributes to my getting worse and more dependent on them.
I feel absolutely miserable despite 20mg d-amphetamine 3x/day and cannot do this anymore. I am in too good a situation to lose the battle now. I only took one 30mg dose of cymbalta the past tuesday; it made me so much worse I had to fight to keep from planning a suicide. I have tried to convince my doctor the necessity of my combining an MAOI with d-amphetamine. I cannot afford to be either euthymic and in a fog, unable to work a job, or have focus but want to die. He will not listen. Apparently--despite the fact I have used psychostimulants on that medication without permission quite a few times to no ill effect--the risk of hypertensive crisis not being able to be managed by an emergency hypertensive is so bad that it is worth totally eliminating any chance I have to get better.
I am so fed up with the fraudulent, disingenuous tradition of American psychiatry. These people only have customers because they never cure patients. I could do a better job of treating myself with a psychologist monitoring me.
I need to know what the risk of serotonin syndrome is after, let's say, 4-7 days of taking the last dose. I have my own ideas, but I do not trust myself to make that determination right now.
Posted by SLS on March 3, 2006, at 16:00:50
In reply to MAOI/cymbalta washout question, posted by Chairman_MAO on March 3, 2006, at 13:07:30
I wish I could answer your question with confidence. I can't. It might be helpful for me to report to you that a single 25mg dose of venlafaxine (immediate release) added to an ongoing treatment with Parnate 120mg produced a serious SS that lasted for about an hour. That's pretty quick clearance. The reaction began within 30 minutes of ingestion. That's pretty quick toxicity. It will probably take a few days for you to achieve significant MAO inhibition anyway. Unfortunately, I don't have the time to surf the Net for information, but if you discover how readily Cymbalta hops off the transporter, I'd like to know.
- Scott
Posted by Chairman_MAO on March 3, 2006, at 16:08:47
In reply to Re: MAOI/cymbalta washout question, posted by SLS on March 3, 2006, at 16:00:50
I know the t1/2 is 12-20hr about. I am not sure about how quickly it dissociates.
I took more buprenorphine and now at least I am a little calmer and not on the virge of tears. That stuff has to be overall one of the best drugs available to psychiatrists, without a doubt. No one should claim that there are no fast-acting antidepressants, because buprenorphine IS a fast-acting antidepressant with long-term efficacy. Have you ever tried it? It is somewhat like other opioids, but very different nonetheless. I do not like taking a lot of it though because it kills my appetite more, etc.
I am hoping at the very least my pdoc will give me a short-term benzo to take this week if I cannot start nardil right away. I am not sure how I am even going to pay for nardil as i do not have medicaid anymore, but I guess I will work something out. And this doesnt even address the fact that I cannot function sexually on Nardil very well or at all. But at this point that is a nonissue.
Funny how when the medication is working and I am not depressed, I am confident that I can drop it and survive just on dexedrine--all in the name of getting my libido and potency back. Now that im not on it, I am kicking myself. But that is part and parcel of depression, ugh
Posted by Phillipa on March 3, 2006, at 21:40:13
In reply to Re: MAOI/cymbalta washout question » SLS, posted by Chairman_MAO on March 3, 2006, at 16:08:47
Right now sex is the least of your problems. Sorry. Love Phillipa
Posted by Questionmark on March 4, 2006, at 1:44:11
In reply to MAOI/cymbalta washout question, posted by Chairman_MAO on March 3, 2006, at 13:07:30
> Has anyone here stopped an SSRI drug with a 24-hour halflife or less and started an MAOI in less than two weeks?
No, but i assume that it would be far more risky to stop Nardil and start an SSRI in less than two weeks. But..
i think you should start the Nardil after 72 hours to a week. Just start with half a pill-- a 1/4 if you really want to be safe and youre taking it in a few days-- then wait about 60 mins and if you're okay take the rest of the 15mg. i can't guarantee safety of course but this is what i would do. Do you happen to have any Remeron or cyproheptadine on hand just in case?
Anyway, in my opinion, you can start cautiously taking low doses of Nardil after several days or so. Just be careful, and sufficiently patient.
Also, remember that the pain you're feeing and the terrible thoughts you're thinking will go away soon, once you can quell this withdrawal, and esp once you can get on Nardil again. Heck, you may even want to write some of your thoughts down so you can analyze their accuracy and such when you're on Nardil again. i wish you the best.If I do not get out of this hole soon I am not going to be able to continue supporting myself and will have to go back to my parents' house. They do not understand me whatsoever and will only do whatever it is contributes to my getting worse and more dependent on them.
>
> I feel absolutely miserable despite 20mg d-amphetamine 3x/day and cannot do this anymore. I am in too good a situation to lose the battle now. I only took one 30mg dose of cymbalta the past tuesday; it made me so much worse I had to fight to keep from planning a suicide. I have tried to convince my doctor the necessity of my combining an MAOI with d-amphetamine. I cannot afford to be either euthymic and in a fog, unable to work a job, or have focus but want to die. He will not listen. Apparently--despite the fact I have used psychostimulants on that medication without permission quite a few times to no ill effect--the risk of hypertensive crisis not being able to be managed by an emergency hypertensive is so bad that it is worth totally eliminating any chance I have to get better.
>
> I am so fed up with the fraudulent, disingenuous tradition of American psychiatry. These people only have customers because they never cure patients. I could do a better job of treating myself with a psychologist monitoring me.
>
> I need to know what the risk of serotonin syndrome is after, let's say, 4-7 days of taking the last dose. I have my own ideas, but I do not trust myself to make that determination right now.
This is the end of the thread.
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