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Dr. Bob is Robert Hsiung, MD,
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Posted by uncouth on November 2, 2008, at 9:35:09
Anyone have any experience adding modafinil (or adrafinil) to parnate to counter some of the tiredness parnate tends to generate, especially in the afternoon. I'd hate to add yet another med to my regime, but I like modafinil's non-speedy wakefulness effects, and it really tends to help my ADHD and concentration issues. Parnate has helped with that independently, but it's not as strong as a stimulant, and when I used to be on Focalin, it was like a miracle in terms of concentration and getting things done. But I know methylphenidate and parnate is a bit dangerous, although it's been done in the past it seems, and my pdoc won't likely let me go there.
But what about modafinil augmentation for MAOIs? Anyone have any insight please?
If I added it, my med regime would be:
50mg parnate
5mg abilify
(200 mg modafinil)at night:
50-100mg seroquel depending on how much i need to sleep
450 lithiumWould like to ask my dr. about modafinil at next appt. so any studies or subjective experiences with parnate would help.
Also, would modafinil have any interactions with the abilify?
Thanks
uncouth
Posted by azalea on November 2, 2008, at 10:23:47
In reply to Parnate plus Modafinil, posted by uncouth on November 2, 2008, at 9:35:09
A PubMed search of "modafinil + parnate" brings up the following 2 articles:
Sleep Med. 2004 Sep;5(5):509-11.
Concomitant use of modafinil and tranylcypromine in a patient with narcolepsy: a case report.
Clemons WE, Makela E, Young J.
Michael S. Aldrich Sleep Disorders Laboratory, Department of Neurology, University of Michigan, 8D 8702 University Hospital, Box 0117, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0117, USA. ec2285@msn.comThis is a case report of a patient with narcolepsy treated simultaneously with modafinil and tranylcypromine. The concurrent use of these two medications is normally contraindicated based on theoretical concerns. To our knowledge this is the first report of the combined use of these two medications in a patient for any reason. This combination of medications was particularly effective in the treatment of the patient's narcoleptic symptoms and was well tolerated, with no evidence of the potential cardiovascular side effects. Due to modafinil's lack of sympathomimetic activity and unique pharmacological profile, it may be well tolerated with monoamine oxidase inhibitor's (MAOI's) in humans with respect to hemodynamic parameters and concerns of hypertensive crisis. Further investigation would help clarify cardiovascular safety issues in using this combined therapy. We believe that with proper informed consent from the patient and careful monitoring, a combination of an MAOI and modafinil may be a viable treatment alternative in refractory cases of narcolepsy.
------------------------------------------------
Am J Psychiatry. 2007 Apr;164(4):684.Acute chorea and hyperthermia after concurrent use of modafinil and tranylcypromine.
Vytopil M, Mani R, Adlakha A, Zhu JJ.
(no abstract available)
> Anyone have any experience adding modafinil (or adrafinil) to parnate to counter some of the tiredness parnate tends to generate, especially in the afternoon. I'd hate to add yet another med to my regime, but I like modafinil's non-speedy wakefulness effects, and it really tends to help my ADHD and concentration issues. Parnate has helped with that independently, but it's not as strong as a stimulant, and when I used to be on Focalin, it was like a miracle in terms of concentration and getting things done. But I know methylphenidate and parnate is a bit dangerous, although it's been done in the past it seems, and my pdoc won't likely let me go there.
>
> But what about modafinil augmentation for MAOIs? Anyone have any insight please?
>
> If I added it, my med regime would be:
> 50mg parnate
> 5mg abilify
> (200 mg modafinil)
>
> at night:
> 50-100mg seroquel depending on how much i need to sleep
> 450 lithium
>
> Would like to ask my dr. about modafinil at next appt. so any studies or subjective experiences with parnate would help.
>
> Also, would modafinil have any interactions with the abilify?
> Thanks
> uncouth
Posted by azalea on November 2, 2008, at 10:31:27
In reply to Parnate plus Modafinil, posted by uncouth on November 2, 2008, at 9:35:09
Epocrates drug interaction checker shows "caution advised" for modafinil + Parnate, but "Contraindicated" for methylphenidate + Parnate, no interaction for Abilify + modafinil.
> Anyone have any experience adding modafinil (or adrafinil) to parnate to counter some of the tiredness parnate tends to generate, especially in the afternoon. I'd hate to add yet another med to my regime, but I like modafinil's non-speedy wakefulness effects, and it really tends to help my ADHD and concentration issues. Parnate has helped with that independently, but it's not as strong as a stimulant, and when I used to be on Focalin, it was like a miracle in terms of concentration and getting things done. But I know methylphenidate and parnate is a bit dangerous, although it's been done in the past it seems, and my pdoc won't likely let me go there.
>
> But what about modafinil augmentation for MAOIs? Anyone have any insight please?
>
> If I added it, my med regime would be:
> 50mg parnate
> 5mg abilify
> (200 mg modafinil)
>
> at night:
> 50-100mg seroquel depending on how much i need to sleep
> 450 lithium
>
> Would like to ask my dr. about modafinil at next appt. so any studies or subjective experiences with parnate would help.
>
> Also, would modafinil have any interactions with the abilify?
> Thanks
> uncouth
Posted by jnew12 on November 2, 2008, at 10:33:13
In reply to PubMed » uncouth, posted by azalea on November 2, 2008, at 10:23:47
I want this to combat Nardil tiredness but I am afriad my doctor wont let me try this because it does say it is condradicted in the PI. He is careful because I don't think he has much experience with MAOI's, let alone MAOI's and other drugs, he almost freaked when I told him that I was taking suboxone.
Posted by Nadezda on November 2, 2008, at 12:20:59
In reply to Parnate plus Modafinil, posted by uncouth on November 2, 2008, at 9:35:09
I took parnate with modafinil for three or four years without any problems.
I also take it with Emsam and abilify, also without any problems at all. I take a very small dose of abilify, and I'm not sure if dose makes a difference.
He never expressed any concern about the use of modafinil, though.
Nadezda
Posted by uncouth on November 2, 2008, at 13:49:29
In reply to Re: Parnate plus Modafinil » uncouth, posted by Nadezda on November 2, 2008, at 12:20:59
can you talk about your experiences taking parnate and emsam plus modafinil? Did you take 200mg of modafinil? what were your doses of parnate and emsam? why did you augment with modafinil...was it for fatigue or was it for stimulation/attention?
Posted by Nadezda on November 3, 2008, at 9:50:51
In reply to Re: Parnate plus Modafinil » Nadezda, posted by uncouth on November 2, 2008, at 13:49:29
Hi, uncouth.
I think I was taking 300 mg of modafinil with the parnate. I had been taking it before it began parnate, because I had pretty constant insomnia, and was often very tired. It also helped my mood. (This was before I began taking Anti-depressants per se.) I continued it with the parnate, which caused me to be very sleepy all the time and also disrupted my sleep quality--although I was sleeping many more hours. For a significant part of the time, I was taking 100 mg. of parnate.
At some point, I found that the modafinil wasn't working as well, and took a few months off. Since I restarted I've stayed at 200 mg, although I might use 300 mg if it seemed necessary.
I'm taking 12 mg Ensam.
Hope this helps.
Nadezda
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