![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by g_g_g_unit on July 21, 2012, at 8:52:12
Since my psychiatrist wasn't really familiar with using MAOIs for OCD, I e-mailed the head of Yale's OCD department and he said he usually keeps patients on an MAOI for 3 months before giving up.
I've been on Parnate for 5 months now, though he was referring to the maximum dose, not overall titration period. Technically, I've only been on 60mg for 5 weeks.
Anyway, I wasn't really finding 60mg helpful - quite agitating, and my mood was quite flat/listless during the day (though I'm not sure how much the 1.5mg Klonopin I take at night contributes to that).
So I cut back to 50mg for a week and experienced the worst crying/suicidal episodes etc. I was kinda down on 60mg, but at least my mood was even, I guess.
Anyway, since Parnate isn't doing much for anxiety or depression, my psych was thinking of taking me off it, but I have a really stressful time coming up over the next 4 weeks and at the very least it gets me out of bed, doing stuff. So he figured I stay on it for that period and at least then, after 9 weeks, we'd have a better idea of whether anything positive might happen.
So he's suggested I add in an extra dose of Klonopin in the morning (0.5mg) to see if it helps the daytime agitation.
He said he didn't think the difference between 50 and 60mg would be much, but I don't know. I'm still on 50mg now and wondering if I should just go back to 60mg and see if it's tolerable with the Klonopin. I wasn't sure if the crying etc. on 50mg was a result of withdrawal, or just an insufficient dose (since too much DA/NE, not enough SE tends to have that effect on me).
Again, I also think the Klonopin itself makes things kinda worse .. I don't know if 1.5mg is a lot, but ideally I'd like to try cut back.
Posted by SLS on July 21, 2012, at 12:49:52
In reply to Parnate decision, posted by g_g_g_unit on July 21, 2012, at 8:52:12
> So I cut back to 50mg for a week and experienced the worst crying/suicidal episodes etc.
Are crying and suicidal episodes ever a part of your depression? I find that my symptoms are at their worst right at the beginning of a relapse, whether it be from drug poop-out, dosage reduction, or ultra rapid cycling.
In my experience, there can be a dramatic difference in the therapeutic effects of Parnate when 50 mg/day is compared to 60 mg/day. Going from 50 to 60 is a 20% increase. That is substantial.
What are the depressive symptoms that Parnate has remedied? Which have persisted?
My guess is that the depressive symptoms you experience when reducing the dosage of Parnate from 60 mg/day to 50 mg/day is more of a relapse than a withdrawal phenomenon. You might get some REM rebound and vivid dreams, but probably not that much.
Parnate does not sound like a good drug for you. You gave it every chance to work, and have been very resolved an patient while taking it.
What is your history with Nardil?
I was under the impression that Nardil was more often effective than Parnate when treating OCD, and probably less anxiogenic. Perhaps this is an old idea. Has the doctor at Yale ever commented on this?
You are in a difficult situation right now, and I don't know of any sure ways to make it any easier. To discontinue Parnate and endure a washout period will be painful. It would be interesting to know what your doctors recommend as a "bridge" between treatments. As for using a benzodiazepine, Xanax might be better than Klonopin. Xanax has some antidepressant properties. Even using Zyprexa temporarily is an option.
- Scott
Posted by g_g_g_unit on July 22, 2012, at 8:39:45
In reply to Re: Parnate decision » g_g_g_unit, posted by SLS on July 21, 2012, at 12:49:52
> > So I cut back to 50mg for a week and experienced the worst crying/suicidal episodes etc.
Thanks Scott. I was hoping I'd hear from you.
>
> Are crying and suicidal episodes ever a part of your depression? I find that my symptoms are at their worst right at the beginning of a relapse, whether it be from drug poop-out, dosage reduction, or ultra rapid cycling.The crying (or increased emotions) I've tended to notice more on noradrenergics. In my depressed state, I'm quite numb, but yeah, suicidal planning plays a big part.
>
> In my experience, there can be a dramatic difference in the therapeutic effects of Parnate when 50 mg/day is compared to 60 mg/day. Going from 50 to 60 is a 20% increase. That is substantial.Yeah, I thought it might be. I don't want to knock my psychiatrist -- because he's highly knowledgeable in other areas -- but MAOIs just aren't something he deals with, and he didn't think dropping 10mg would be enough to produce a depressive rebound.
>
> What are the depressive symptoms that Parnate has remedied? Which have persisted?It's helped leaden paralysis and I guess made me more likely to keep busy, but I live in a highly stressful home environment, so the busyness is also quite anxiety-driven (I notice more anxiety/agitation on Parnate). It's also helped rejection sensitivity. This dose is overstimulating, but there are windows (or points on the U-curve, I suppose) where my ADD is improved.
One thing I've noticed, or did previously, was that, at night, I'd experience this amazing effect - it was nothing like hypomania (I had a little of that on Nardil). My emotions just felt warmer, I felt genuinely happy, optimistic, close to others. I thought that might be indicative of what the AD response would be like, but sadly, its disappeared.
>
> My guess is that the depressive symptoms you experience when reducing the dosage of Parnate from 60 mg/day to 50 mg/day is more of a relapse than a withdrawal phenomenon. You might get some REM rebound and vivid dreams, but probably not that much.
>
> Parnate does not sound like a good drug for you. You gave it every chance to work, and have been very resolved an patient while taking it.I suppose you're right. I just figured it would be fair to give it the 3 months for anxiety, though it's proving hard. My guess is I'll stay on it for the next few weeks -- because like I say, now is a bad time to withdraw -- and then call it quits if there's no difference (which would be 9 weeks @ 60mg).
>
> What is your history with Nardil?Tried it. Got up to 75mg and felt pretty anxious/couldn't sleep. I definitely didn't give it a fair chance, though, as I think I gave up on 75mg after a few weeks. The trial was about 2 months total.
The problem is the only sleep aid I can tolerate is Clonazepam. Every other one produces rebound.
>
> I was under the impression that Nardil was more often effective than Parnate when treating OCD, and probably less anxiogenic. Perhaps this is an old idea. Has the doctor at Yale ever commented on this?Not specifically, no. He just said he found MAOIs in general effective for OCD comorbid with panic.
>
> You are in a difficult situation right now, and I don't know of any sure ways to make it any easier. To discontinue Parnate and endure a washout period will be painful. It would be interesting to know what your doctors recommend as a "bridge" between treatments. As for using a benzodiazepine, Xanax might be better than Klonopin. Xanax has some antidepressant properties. Even using Zyprexa temporarily is an option.
>
Thanks for the recommendation. It's strange, but not even the 1.5mg of Klonopin I take at night does much for daytime anxiety (somatic or otherwise), and the extra 0.5mg I added in the morning today was like a sugar pill. I've just gone from 50mg back to 60mg after a week's break though, so maybe there's more initial anxiety.Yeah I think I preferred Xanax. My doctor tried me on a low dose (0.25mg four times a day), then stopped when it didn't work. But when I self-experimented with 0.5mg it was a good anxiolytic.
I've convinced my doctor to let me try Memantine with Dexedrine as an anti-depressant combination next, as I think that'd give me more success in the ADD realm (and hopefully help anxiety too, since Memantine was quite beneficial in that respect last time I tried it). Failing that, I might resort to Nardil, but I guess I just don't think it'll do anything for ADD.
Posted by jono_in_adelaide on July 24, 2012, at 22:12:48
In reply to Parnate decision, posted by g_g_g_unit on July 21, 2012, at 8:52:12
1.5mg of clonazepam is ~ equivalent to 15mg of diazepam I think
Have you tried Nardil?
A combo that might be worth investigating would be nardil plus nortriptyline - if you're at the end of the road, I'd atleast seriously consider trying it.
Posted by phidippus on July 26, 2012, at 22:24:11
In reply to Parnate decision, posted by g_g_g_unit on July 21, 2012, at 8:52:12
MAOIs are reccommended as a last line of treatment according to the APA treatment algorithm for OCD. Parnate is not working for you and its time to give it up.
According to the APA treatment algorithm for OCD, the first line of treatment medicine wise is an SSRI. If you fail to respond to the SSRI or there is only moderate improvement, the APA recommends augmentation with an atypical antipsychotic.
The logic is thus: in patients with OCD it has been shown that there are deficiencies in seratonin in the prefrontal cortex-glutamate levels are also too high. Treatment with an SSRI boosts deficient levels of seratonin and corrects the imbalance. It doesn't stop there though. It has also been shown that folk with OCD have elevated levels of dopamine in the nucleus acumbens. Augmentation with an atypical antipsychotic corrects this imbalance.
I have OCD and am doing great, mostly due to the fact I follow th APA guidelines for the treatment of OCD. My meds are:
Viibryd 60 mg
Lithium 1200 mg
Abilify 10 mg
Klonopin 2 mgTry the formula. Get on an SSRI at a therapeutic level, then augment with an atypical antipsychotic. Parnate is just the wrong choice.
Eric
Posted by SLS on July 27, 2012, at 7:30:59
In reply to Re: Parnate decision » g_g_g_unit, posted by phidippus on July 26, 2012, at 22:24:11
Nice post.
- Scott
> MAOIs are reccommended as a last line of treatment according to the APA treatment algorithm for OCD. Parnate is not working for you and its time to give it up.
>
> According to the APA treatment algorithm for OCD, the first line of treatment medicine wise is an SSRI. If you fail to respond to the SSRI or there is only moderate improvement, the APA recommends augmentation with an atypical antipsychotic.
>
> The logic is thus: in patients with OCD it has been shown that there are deficiencies in seratonin in the prefrontal cortex-glutamate levels are also too high. Treatment with an SSRI boosts deficient levels of seratonin and corrects the imbalance. It doesn't stop there though. It has also been shown that folk with OCD have elevated levels of dopamine in the nucleus acumbens. Augmentation with an atypical antipsychotic corrects this imbalance.
>
> I have OCD and am doing great, mostly due to the fact I follow th APA guidelines for the treatment of OCD. My meds are:
>
> Viibryd 60 mg
> Lithium 1200 mg
> Abilify 10 mg
> Klonopin 2 mg
>
> Try the formula. Get on an SSRI at a therapeutic level, then augment with an atypical antipsychotic. Parnate is just the wrong choice.
>
> Eric
Posted by g_g_g_unit on July 27, 2012, at 7:33:04
In reply to Re: Parnate decision, posted by jono_in_adelaide on July 24, 2012, at 22:12:48
> 1.5mg of clonazepam is ~ equivalent to 15mg of diazepam I think
>
> Have you tried Nardil?Yeah, I have. The side-effects were bothersome, but I'd possibly consider it again as a last resort.
>
> A combo that might be worth investigating would be nardil plus nortriptyline - if you're at the end of the road, I'd atleast seriously consider trying it.
Posted by g_g_g_unit on July 27, 2012, at 7:51:14
In reply to Re: Parnate decision » g_g_g_unit, posted by phidippus on July 26, 2012, at 22:24:11
> MAOIs are reccommended as a last line of treatment according to the APA treatment algorithm for OCD. Parnate is not working for you and its time to give it up.
>
> According to the APA treatment algorithm for OCD, the first line of treatment medicine wise is an SSRI. If you fail to respond to the SSRI or there is only moderate improvement, the APA recommends augmentation with an atypical antipsychotic.
>
> The logic is thus: in patients with OCD it has been shown that there are deficiencies in seratonin in the prefrontal cortex-glutamate levels are also too high. Treatment with an SSRI boosts deficient levels of seratonin and corrects the imbalance. It doesn't stop there though. It has also been shown that folk with OCD have elevated levels of dopamine in the nucleus acumbens. Augmentation with an atypical antipsychotic corrects this imbalance.
>
> I have OCD and am doing great, mostly due to the fact I follow th APA guidelines for the treatment of OCD. My meds are:
>
> Viibryd 60 mg
> Lithium 1200 mg
> Abilify 10 mg
> Klonopin 2 mg
>
> Try the formula. Get on an SSRI at a therapeutic level, then augment with an atypical antipsychotic. Parnate is just the wrong choice.
>
> EricNot everyone has to live within the APA guidelines. I know a girl who's had severe OCD since she was 8. Despite being tried on SSRIs, anti-psychotics, etc., she was unable to complete high school and now, at 23, remains at home. She's chosen to combine Dexamphetamine with a mindfulness approach, because she finds SSRIs mentally dulling and not worth the trade-off.
Likewise, SSRIs are anathema to me and I have a sensitivity which prevents me from tolerating high doses of medication anyway. I've tried clomipramine, Seroquel, Zyprexa and none agreed with me. A stimulant with a benzo basically got rid of my obsessive thoughts, but took away most of my other thoughts too.
My doctor has agreed to try Memantine in combination with Dexamphetamine. If that doesn't provide sufficient anxiety control, I'd add in a low-dose of an SSRI and/or a benzo and deal with any remaining symptoms in therapy.
I'm trying to find a combination that will accord with my own personal values and ambitions. The APA can't account for that, nor can it account for things like metabolic aberrations. If that doesn't work out, and my life was at stake, then I'd turn to a high-dose SSRI or Nardil. But right now, I'm still exercising my freedom to explore.
Posted by phidippus on July 29, 2012, at 11:02:15
In reply to Re: Parnate decision » phidippus, posted by g_g_g_unit on July 27, 2012, at 7:51:14
>My doctor has agreed to try Memantine in >combination with Dexamphetamine. If that doesn't >provide sufficient anxiety control, I'd add in a >low-dose of an SSRI and/or a benzo and deal with >any remaining symptoms in therapy.
My worry is your not addressing the source of the problem: low seratonin.
Eric
Posted by g_g_g_unit on July 29, 2012, at 18:53:23
In reply to Re: Parnate decision » g_g_g_unit, posted by phidippus on July 29, 2012, at 11:02:15
> My worry is your not addressing the source of the problem: low seratonin.
>
> Eric
>
>It's nice to hear you worry. To be honest, sometimes I (mis)read your posts as a little bullying or didactic, more than an attempt to genuinely look out for me.
I'm almost certain I would have to take at least a low dose of an SSRI, because otherwise I suffer from leaden paralysis. 5mg of Lexapro solved that, but I really just don't find SSRIs very useful for anxiety or lifting mood, and higher doses put me in a dissociative state.
Are you under the conviction that symptoms should be totally controlled (to the extent possible) with medication?
I think that social withdrawal, anhedonia and poor cognition have as great an impact on my psyche as OCD. Remember, my primary, or nascent issue was inattentive ADD. From my research, it seems like those with inattentive ADD accompanied by the kind of dysthymia I experience have done well on a combination of amphetamine and Memantine. My worry is preventing downregulation of D2/D3 receptors in the nucleus accumbens could enhance compulsivity, but I don't know how efficient Memantine would be in offsetting that. I just remember finding it tremendously effective (>benzo) for anxiety.
Since I'm sensitive to meds, as I say, maybe I could get away with an average SSRI dose (which would address your low serotonin worry), and make a more concerted effort in therapy (which I've never really done before).
I've tried so much already that I think it's worth a shot. I'm trying to reclaim the life I had prior to depression (even when OCD was around). Maybe that's my mistake, but I guess I'll find out.
Posted by phidippus on July 31, 2012, at 15:37:49
In reply to Re: Parnate decision » phidippus, posted by g_g_g_unit on July 29, 2012, at 18:53:23
>a little bullying or didactic
I call it tough love.
>I really just don't find SSRIs very useful for >anxiety or lifting moodI really just don't find >SSRIs very useful for anxiety or lifting mood
How many have you tried or been on for longer than 5 weeks?
With OCD, symptoms will not be totally controlled by medicine, however, if you find the right meds you can achieve great relief. As for your social withdrawal, anhedonia and poor cognition well...
I don't think you need to worry about d2/d3 donwregulation-compulsivity is not an issue with either the Memantine or the dexamphetamine.
Which SSRI would you choose? Have you ever been on Luvox?
Eric
Posted by SLS on July 31, 2012, at 16:27:18
In reply to Re: Parnate decision » phidippus, posted by g_g_g_unit on July 29, 2012, at 18:53:23
What about adding a small amount of risperidone?
- Scott
Posted by g_g_g_unit on July 31, 2012, at 18:39:36
In reply to Re: Parnate decision » g_g_g_unit, posted by phidippus on July 31, 2012, at 15:37:49
>I call it tough love.
Well, it can be hard to judge tone or intent over the internet. I'm extremely sensitive, particularly when depressed, and sometimes take it personally.
> >I really just don't find SSRIs very useful for >anxiety or lifting moodI really just don't find >SSRIs very useful for anxiety or lifting mood
>
> How many have you tried or been on for longer than 5 weeks?I've been on Luvox (up to 100mg), Lexapro (up to 20mg), Zoloft (25mg) and Prozac (up to 20mg). I stayed on each for at least 2 months.
Luvox gave me terrible restless leg syndrome, but was the best sleep wise.
Lexapro did not do much of anything for anxiety or depression and caused an unpleasant dissociation at higher doses.
Zoloft disturbed sleep too much and caused tremendous anxiety/restlessness at even such a low dose.
Prozac also caused intractible insomnia and did nothing for my anxiety after 8+ weeks.
>
> With OCD, symptoms will not be totally controlled by medicine, however, if you find the right meds you can achieve great relief. As for your social withdrawal, anhedonia and poor cognition well...
>
> I don't think you need to worry about d2/d3 donwregulation-compulsivity is not an issue with either the Memantine or the dexamphetamine.But you're aware my aim was to take the Memantine first, then add in the Dexamphetamine, which I understand improves mood and anxiety by preventing downregulation of d2/d3 receptors? It seems like some posters here (you included?) simply added Memantine to their pre-existing stimulant regime, which would have different results.
>
> Which SSRI would you choose? Have you ever been on Luvox?Yes, see above. Luvox and Lexapro were perhaps the most tolerable. You also have to take into account the fact that I have a bizarre sensitivity to meds, and cannot tolerate normal doses of anything. My psychiatrist wanted to run metabolic testing, but I couldn't afford it, so he simply acts under the assumption that I'm a slow metabolizer.
Posted by g_g_g_unit on July 31, 2012, at 18:41:46
In reply to Re: Parnate decision » g_g_g_unit, posted by SLS on July 31, 2012, at 16:27:18
> What about adding a small amount of risperidone?
>
>
> - ScottI thought about something like that. I tried risperdone once, but found it exacerbated my anxiety. I guess I wouldn't want to interfere too much with the motivational/anti-anhedonic aspects of Memantine and Dexedrine.
Posted by phidippus on July 31, 2012, at 20:22:58
In reply to Re: Parnate decision » g_g_g_unit, posted by SLS on July 31, 2012, at 16:27:18
Parnate + Risperidone. Hmmm, I think that might cause an interaction. Otherwwise, Risperidone is great for agitated states.
Eric
Posted by phidippus on July 31, 2012, at 20:34:35
In reply to Re: Parnate decision » phidippus, posted by g_g_g_unit on July 31, 2012, at 18:39:36
I know you're sensitive. Don't take my being stern as anything other than caring.
Why not try Luvox again, but supplement it with Requip? You might like what Requip may do for your anhedonia.
My experiments with Memantine started with taking it alongside Lithium. I had immediate results, especially with my mood.
I don't think its going to matter which drug you start with-dexamphetamine will be felt immediately.
Have you ever tried Keppra?
Eric
Posted by g_g_g_unit on July 31, 2012, at 22:16:08
In reply to Re: Parnate decision » g_g_g_unit, posted by phidippus on July 31, 2012, at 20:34:35
> Why not try Luvox again, but supplement it with Requip? You might like what Requip may do for your anhedonia.
I thought long-term efficacy of Parkinson's agents was questionable? I've also heard of Memantine interfering with Requip (can't recall how exactly).
>
> My experiments with Memantine started with taking it alongside Lithium. I had immediate results, especially with my mood.
>
> I don't think its going to matter which drug you start with-dexamphetamine will be felt immediately.
>Sorry, what I meant was, don't D2/D3 receptors in the nucleus accumbens downregulate with chronic amphetamine use? And that these receptors are responsible for its anxiolytic, (slightly?) euphoric, mood-boosting effects? Therefore, adding Memantine to a pre-existing amphetamine regime wouldn't alter that?
The idea of adding Memantine first (and concomitantly abstaining from amphetamine for several weeks), is, from my understanding, to prevent that reward-center downregulation or "tolerance".
However, you noted that OCD (or compulsivity, I'm guessing) is correlated with elevated dopamine levels in the nucleus accumbens, which is why, as wonderful as the combination sounds for anhedonia and motivational issues, I wonder if it could make OCD a lot worse.
That's why I thought perhaps a lower dose of Luvox or Lexapro might help compulsivity, without losing the positive effects on reward. I'm in therapy, and making a little progress, so would be happy to make the trade-off of less symptom control.
As I've stated before, interpersonal values come into play here a lot. As bad as my OCD is, I really need to deal with my anhedonia, motivational and cognitive issues so I can socialize, ideally return to work (in a creative field) and get the **** out of my parents' house. Adding amphetamine to an SSRI alone didn't really do much for those issues, which is why I'm interested in the Memantine-Dex thing.
> Have you ever tried Keppra?No. How might it benefit me?
>
> Eric
>
Posted by phidippus on August 1, 2012, at 14:56:20
In reply to Re: Parnate decision » phidippus, posted by g_g_g_unit on July 31, 2012, at 22:16:08
>I thought long-term efficacy of Parkinson's agents >was questionable? I've also heard of Memantine >interfering with Requip (can't recall how exactly).
I've known people that have been on Requip for years and it does its jobb. There are no known interactions between Memantine and Requip.
>adding Memantine to a pre-existing amphetamine >regime wouldn't alter that?
Not at all.
>I wonder if it could make OCD a lot worse
Requip? It never made my OCD worse. There is an increases risk for compulsive behavior, such as gambling and risk-taking sex.
Do you have compulsions?
Keppra effects AMPA, which fine tuness NMDA transmission. Keppra might work well as an anxiolytic for you.
Eric
Posted by g_g_g_unit on August 1, 2012, at 19:21:13
In reply to Re: Parnate decision » g_g_g_unit, posted by phidippus on August 1, 2012, at 14:56:20
> >adding Memantine to a pre-existing amphetamine >regime wouldn't alter that?
>
> Not at all.
>
> >I wonder if it could make OCD a lot worse
>
> Requip? It never made my OCD worse. There is an increases risk for compulsive behavior, such as gambling and risk-taking sex.
>>
Sorry, I don't think made myself very clear. What I meant was that, as we all know, there's an initial 'honeymoon' period on stimulants for a lot of people where sociability, liveliness etc. is increased. After 3 or so days, that (including the anxiolysis) is replaced by a more mechanical sense of motivation, increased anxiety, irritability etc. (at least in my case -- as well as that of several others I've spoken to).
So taking a break from stimulants, *then* adding Memantine, *then* resuming the stimulant is supposed to preserve that enhanced sense of reward, pleasure, etc., which I think stems from preventing downregulation of the D2/D3 receptors in the nucleus accumbens.
Here is a quote from another forum:
"However, for our theoretical model in this use (that glutamate hyperexcitation in the nucleus accumbens core occurs secondary to amphetamine use, and that this glutamate hyperexcitation is responsible for downregulating nucleus accumbens core dopamine sensitivity, which is the additional mechanism responsible for the faster tolerance to mood/motivational effects from amphetamine than to concentrative effects, which are mostly mediated prefrontally, where there is both desensitization occurring for instance at tyrosine hydroxylase and the dopamine receptor end, and sensitization probably via neuroplastic mechanisms), there is a wide, complex, shadowy body of work to point to."
If you had already been taking stimulants for some time, and then added Memantine without first taking a break, the re-sensitization of those receptors wouldn't occur (again, from anecdotal reports I've come across).
So my point is, if my interest lies in the first application, i.e. *preserving* reward in the nucleus accumbens by introducing Memantine first, *then* the stimulant, wouldn't that exacerbate OCD (as you mentioned in your Abilify post - OCD is linked to higher levels of dopamine in the reward center).
> Do you have compulsions?
Yes, I suppose so. My OCD primarily consists of mental rituals and avoidance. I have some compulsions, but I think they hold a stronger link to personality traits and childhood trauma (i.e. some narcissistic compulsions; compulsively pleasing others to stave off abandonment).
Posted by SLS on August 1, 2012, at 20:06:22
In reply to Re: Parnate decision » phidippus, posted by g_g_g_unit on August 1, 2012, at 19:21:13
Makes sense to me.
:-)
You're really getting into this stuff! I hope it pays off. Please keep posting. I really appreciate the sophistication with which you address biological psychiatry. I hope to learn more from you.
Please, please, please post your results of memantine pretreatment and subsequent administration of a psychostimulant.
How long do you think one would need to abstain from taking a stimulant before restarting it so that you can obtain the desired results?
- Scott
Posted by g_g_g_unit on August 1, 2012, at 20:20:23
In reply to Re: Parnate decision » g_g_g_unit, posted by SLS on August 1, 2012, at 20:06:22
> Makes sense to me.
>
> :-)
>
> You're really getting into this stuff! I hope it pays off. Please keep posting. I really appreciate the sophistication with which you address biological psychiatry. I hope to learn more from you.
>
> Please, please, please post your results of memantine pretreatment and subsequent administration of a psychostimulant.
>
> How long do you think one would need to abstain from taking a stimulant before restarting it so that you can obtain the desired results?
>
>
> - ScottThanks SLS, but I really can't take any credit for this. Most of the theorizing came from the poster responsible for the included quote (including andrewB, temoigneur, etc. on this forum) .. I just regurgitated a watered-down version.
Again, it sounds good on paper, but I'm a little worried about the induction of compulsivity or stereotypical behavior.
Anyway, my psychiatrist can sometimes be flaky .. he agreed to the Memantine/Dex idea a month ago when I asked, but had refused Memantine several months prior to that. I'm going to present the idea to him again tomorrow, so I really hope he doesn't turn me down. I am just very desperate and rather near the end of my tether, so I don't think the logic for me wanting to try it is unreasonable.
I'm not sure re: how long one would need to abstain from a stimulant. I guess it might depend on individual tolerance/sensitivity? Though it seems like tapering off completely, adjusting to Memantine (over a period of a couple of weeks or so) and then reintroducing the stimulant was sufficient for most people.
If you want an ecstatic report of the combination, maybe revisit temoigneur's "happy ending :P" post in the archives. I believe he remitted from 7+ years of severe OCD with psychotic features and was able to return to university on a combination of Prozac, Memantine and Dexedrine. I've tried to chase him down to see how he's doing (as I found a post in another forum where he relapsed two years later), but haven't had much luck.
Posted by Resistant on August 9, 2012, at 6:37:46
In reply to Re: Parnate decision » SLS, posted by g_g_g_unit on August 1, 2012, at 20:20:23
I'm interested in your progress g_g_g_unit , have you got any updates ?
Also I have been reading a lot of threads about Parnate over the last week or so ( probably 2 much)and just wanted to say I really enjoy reading your posts scott.
Posted by SLS on August 9, 2012, at 6:57:46
In reply to Re: Parnate decision, posted by Resistant on August 9, 2012, at 6:37:46
Hi Resistant.
> Also I have been reading a lot of threads about Parnate over the last week or so ( probably 2 much)and just wanted to say I really enjoy reading your posts scott.
Your compliment is well-timed. I needed to hear that today.Thanks.
- Scott
This is the end of the thread.
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