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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Peter Gibbons on November 20, 2013, at 17:24:18
Is this an excellent combo for prosociability/combatting Nardil fatigue/treating A.D.D.?
I was going to use Nuvigil alongside Nardil but it is being denied for coverage by my insurance and I am in a position where my psychiatrist will probably be willing to prescribe this combo to me (long story)
And if anyone has been on this combo, or heard anecdotes about it, is there any advice you have on how quickly to titrate the amount of Dextroamphetamine, what timing of day to take the Dextro and the Nardil, what dosage of Nardil worked best with it, etc?
Posted by nix on November 21, 2013, at 2:54:44
In reply to Nardil + Dextroamphetamine, posted by Peter Gibbons on November 20, 2013, at 17:24:18
You will want to be very careful with this. And no, I would not characterize it as an 'excellent combo'. I only just started an MAOI (EMSAM) + Dexedrine myself, but I've been taking Dexedrine for years for ADD/depression/fatigue. I was taking 90mg/day (30mg TID) before starting the MAOI. My psychiatrist had me clear the Dexedrine from my system completely first, then titrate up the MAOI, then re-added the Dexedrine at 1/3 my previous dose (30mg/day) max. I would say this is about correct; my sensitivity is about three times greater; I'm titrating up 5mg/day. The duration of action is now much longer, 10 hours instead of 4-5, so I've switched to once-a-day dosing. I am also seeing an uncomfortable increase in my heart rate (just above 100bpm resting), even at 5mg/day, although this doesn't seem to be dose-dependent.
I also would not characterize it as pro-social, as it has also increased my anxiety substantially. I'm now having to take 3mg Klonopin per day (up from 1mg).
If your system is naive to classic stimulants, I definitely would not take more than 10mg/day of Dexedrine until you are very sure of how this will affect your BP/HR and anxiety and how long it will kick around in your system.
Posted by Peter Gibbons on November 21, 2013, at 4:19:59
In reply to Re: Nardil + Dextroamphetamine, posted by nix on November 21, 2013, at 2:54:44
I've been on stimulants for quite some time (Adderall/Vyvanse) and am very familiar with how they feel/drawbacks/etc. Nardil is literally the only antidepressant I've ever been on that works, treats my anxiety brilliantly thru it's raising of GABA levels and increase of dopamine + serotonin.
The only problem is, I truly have ADD and Nardil makes this way worse. I know that a stimulant + Nardil would be the ultimate combination for me and probably get me pretty damn close to 100% remission of symptoms, just gotta be careful with the dosing as you said. I think nardil's effect on GABA and serotonin will probably take care of any increased anxiety from dex, even tho i never really got any anxiety from it to begin with
So the duration of Dextroamphetamine's effects is increased alot when being on an MAOI? That seems great hahah!
Posted by stargazer2 on November 21, 2013, at 22:04:37
In reply to Re: Nardil + Dextroamphetamine, posted by Peter Gibbons on November 21, 2013, at 4:19:59
I took Amphetamine with a MAO, think it was NArdil and I did fine at 5 mg but had a hypertensive reaction at 7.5 mg so the window for me was very narrow and my pdoc kind of steered clear of prescribing that combo again. It was a scarey experience. It sounds like you have lots of experience with these meds so you know your limits. I treated myself with Nifedipine and monitored my BP until it come back to normal. It went up to 250/140 or somewhere in that range. Going to the ER wasn't in my range of possibilities as long as I could manage it.
Posted by Peter Gibbons on November 22, 2013, at 6:46:21
In reply to Re: Nardil + Dextroamphetamine, posted by stargazer2 on November 21, 2013, at 22:04:37
Yikes, that's scary! I will definitely ask her to prescribe Nifedipine alongside the dextro. Was the amphetamine definitely helping up until you got to that 7.5mg point though?
Posted by cee on November 29, 2013, at 1:36:04
In reply to Nardil + Dextroamphetamine, posted by Peter Gibbons on November 20, 2013, at 17:24:18
if you put the nardil in an enteric capsule you will get rid of these bad symptoms
This is the end of the thread.
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