Psycho-Babble Medication Thread 1110056

Shown: posts 1 to 20 of 20. This is the beginning of the thread.

 

Nardil plus lorazepam

Posted by Jadde on May 11, 2020, at 15:46:22

Havent been sleeping while on Nardil, to the point I think its interfering with Nardils benefit. I had a bad day yesterday, frustrated that Nardil wasnt working as it has in the past. So I had a small stash of Lorazepam and I took it at bedtime. I woke up feeling rested and motivated. All day.

Found this in the archives:
https://www.dr-bob.org/babble/20200303/msgs/1110053.html

In addition, my crazy Nardil appetite was/is gone. Any one have experience with this combo, or insight re why this might be a good/bad combo?

I want ask my doc for it, but only if this might last.

Thanks for any help!

Jade

 

Re: Nardil plus lorazepam

Posted by Jadde on May 11, 2020, at 15:48:36

In reply to Nardil plus lorazepam, posted by Jadde on May 11, 2020, at 15:46:22

Oops, wrong link, Ill see if I can find the right one

 

Re: Nardil plus lorazepam

Posted by Jadde on May 11, 2020, at 15:50:46

In reply to Re: Nardil plus lorazepam, posted by Jadde on May 11, 2020, at 15:48:36

http://www.dr-bob.org/babble/20090902/msgs/915982.html

 

Re: Nardil plus lorazepam

Posted by rjlockhart37 on May 12, 2020, at 1:51:43

In reply to Re: Nardil plus lorazepam, posted by Jadde on May 11, 2020, at 15:50:46

lorazepam can be good and bad, if yoour having anxiety about a situation or just in general it can help, but taking through out day, soemtimes can decrease nardil effect, through gaba, which inhibition of nuerotransmitters. It's good for when you need it, but on a regular regimine, with nardil, could somewhat reduce anti-depressant effects

and yes i have found valium much less potent than ativan, its calming but nothing like ativan

 

Re: Nardil plus lorazepam

Posted by Stargazer2 on June 13, 2020, at 22:51:57

In reply to Re: Nardil plus lorazepam, posted by rjlockhart37 on May 12, 2020, at 1:51:43

I had the genetic testing to see what meds would work for me. The MAOs are listed as being good for me. The list also includes drugs in just about every category. So if I couldnt sleep it would give me a couple of sedatives or ADs with hypnotic qualities. Just saying the test is helpful to steer one
In The right direction. Some disagree. I take 25 of Seroquel
At night for insomnia and Nardil 45 every am. I also take DL Phenylalanine and Lithium ER 300. Those I only take once a week. Go figure but it works and I know with taking Nardil many drugs are lethal.

 

Re: Nardil plus lorazepam

Posted by undopaminergic on June 14, 2020, at 6:54:57

In reply to Re: Nardil plus lorazepam, posted by Stargazer2 on June 13, 2020, at 22:51:57

> ... I know with taking Nardil many drugs are lethal.

I think deaths are rare. There are only a few classes of drugs that can be lethal, such as, in particular, SSRIs and some TCAs, and to a lesser extent, amphetamines.

-undopaminergic

 

Re: Nardil plus lorazepam

Posted by Stargazer2 on June 14, 2020, at 9:28:09

In reply to Re: Nardil plus lorazepam, posted by undopaminergic on June 14, 2020, at 6:54:57

I had the reaction once. BP 220/130. On the Bathroom floor sweating and a headache so severe it could have killed me.
I was on Nardil and had taken one dose of Ritalin 10 mg.
Not sure if I was a layperson if I would have survived that one. Libby Zion, famous case in NYC. Doctors at a Large hospital there Missed an interaction between a MAO and another drug. She died. The hospital did not understand the MAO effects. Case study for interns Today . How many people on MAOs wear a med alert bracelet for this reason? I should but dont..

 

Re: Nardil plus lorazepam

Posted by undopaminergic on June 15, 2020, at 3:33:03

In reply to Re: Nardil plus lorazepam, posted by Stargazer2 on June 14, 2020, at 9:28:09

> I had the reaction once. BP 220/130. On the Bathroom floor sweating and a headache so severe it could have killed me.
>

Occipital?

> I was on Nardil and had taken one dose of Ritalin 10 mg.

Did you start on 10 mg?

Normally, you would not expect a severe hypertensive response from that combination, especially as MAOIs have a hypotensive effect.

> Not sure if I was a layperson if I would have survived that one.

How did your professional experience help you survive?

-undopaminergic

 

Re: Nardil plus lorazepam

Posted by Stargazer2 on June 15, 2020, at 13:33:28

In reply to Re: Nardil plus lorazepam, posted by undopaminergic on June 15, 2020, at 3:33:03

Hi there. The reaction is known and high risk. MAOs can cause hypotension on their own but Cause hypertension with other medications that are contraindicated.

Here is the drug interaction listed in Drug.com.

phenelzine methylphenidate
Applies to: Nardil (phenelzine), Ritalin (methylphenidate)
Using phenelzine together with methylphenidate is not recommended. Combining these medications can cause dangerously high blood pressure and even death

Cant remember but dont think it was occipital.
Had a BP cuff and a few Nifedipine pills I took to reduce my pressure. Watched the pressure go from that High level back to under 150/90.. Without a cuff or Antigtpertensive pills on hand I would have had to go to the ER or I might have stroked out.

I started on 5 mg and went up to 10. That was my first dose of 10 mg. I also had that reaction after eating Parmasean cheese.
I take 5 mg now and have never had another reaction but it still could occur.
The pharmacist never fills the prescription for Ritalin until he informs me of the danger of taking Nardil and Ritalin together. I explain my awareness and my doctor knowing I will never take more than 5 mg, separated by at least 6 hours.

 

Re: Nardil plus lorazepam

Posted by undopaminergic on June 16, 2020, at 7:07:17

In reply to Re: Nardil plus lorazepam, posted by Stargazer2 on June 15, 2020, at 13:33:28

I wouldn't say it is "high" risk. Usually, you can combine noradrenaline (but not serotonin) reuptake inhibitors with MAOIs. Moreover, there seem to be plenty of people here who are using even *high* doses of not only Ritalin but amphetamines (the latter being more risky) with MAOIs. Some people ignore the dietary restrictions without problems. There is a risk, but if you don't respond adequately to a MAOI alone, it may be worth taking.

An occipital headache is a classic telltale sign of hypertensive crisis, but maybe that's just the most "typical" localisation.

-undopaminergic

 

Nardil(MAO) plus high dose stimulant/ Anyone?

Posted by Stargazer2 on June 16, 2020, at 18:12:03

In reply to Re: Nardil plus lorazepam, posted by undopaminergic on June 16, 2020, at 7:07:17

So how do you explain what I went through? Have you ever had the hypertensive crisis related to a MAO and Ritalin?
I would like to hear of all the others taking high dose stimulants plus a MAO and hear how many had reactions. I would not think there are many.
As far as food goes yes you may not always have the reaction eating certain foods but can you say confidently you never will.
I think this is one reason doctors will never order MAOs to anyone that doesnt have the ability to understand certain foods or drugs could kill you.
What if I wasnt able to take my pressure or take the drug I did to lower my BP? Most would not have done what I did and the outcome could have been a stroke.

 

Re: Nardil(MAO) plus high dose stimulant/ Anyone?

Posted by undopaminergic on June 17, 2020, at 3:54:57

In reply to Nardil(MAO) plus high dose stimulant/ Anyone?, posted by Stargazer2 on June 16, 2020, at 18:12:03

> So how do you explain what I went through?

I didn't mean your experience was *not* due to the MAOI + Ritalin. It probably was, because it is temporally linked to the 10 mg Ritalin you added.

> Have you ever had the hypertensive crisis related to a MAO and Ritalin?

The only MAOIs I've taken are selegiline and rasagiline, and that probably doesn't count.

> I would like to hear of all the others taking high dose stimulants plus a MAO and hear how many had reactions. I would not think there are many.
>

I can't actually recall anyone (else) who reported a serious hypertensive reaction with a stimulant. That is why I think it is rare.

The relevant mechanism of action of Ritalin in this context is the noradrenaline reuptake inhibition, which is shared with a number of non-stimulant drugs. Ken Gillman, a MAOI expert, suggests that TCAs without serotonin reuptake inhibitory effects are safe to combine with MAOIs.

I did have mixed experience with selegiline + reboxetine. It was in part unpleasant, but I did not measure my blood pressure.

> As far as food goes yes you may not always have the reaction eating certain foods but can you say confidently you never will.
>

Of course not. The dietary restrictions were introduced because some people had serious reactions, some of which were fatal.

According to Gillman, there are very few foods today containing enough tyramine to trigger a serious reaction. That's probably the reason why you (nowadays) get away with ignoring the MAOI diet.

> I think this is one reason doctors will never order MAOs to anyone that doesnt have the ability to understand certain foods or drugs could kill you.
>

Probably.

> What if I wasnt able to take my pressure or take the drug I did to lower my BP? Most would not have done what I did and the outcome could have been a stroke.
>

I'm not saying you did not have a serious reaction.

-undopaminergic

 

Re: Nardil plus lorazepam Jadde

Posted by SLS on June 17, 2020, at 8:12:30

In reply to Nardil plus lorazepam, posted by Jadde on May 11, 2020, at 15:46:22

> Havent been sleeping while on Nardil, to the point I think its interfering with Nardils benefit. I had a bad day yesterday, frustrated that Nardil wasnt working as it has in the past. So I had a small stash of Lorazepam and I took it at bedtime. I woke up feeling rested and motivated. All day.
>
> Found this in the archives:
> https://www.dr-bob.org/babble/20200303/msgs/1110053.html
>
> In addition, my crazy Nardil appetite was/is gone. Any one have experience with this combo, or insight re why this might be a good/bad combo?
>
> I want ask my doc for it, but only if this might last.
>
> Thanks for any help!
>


I would consider taking both zolpidem (short half-life for sleep initiation) and lorazepam (longer half-life for sleep maintenance) at bedtime. It is perfectly safe with Nardil (I do it).

The most effective treatment that I know of for sleep is a combination of triazolam (Halcion) for sleep initiation and lorazepam (Ativan) for sleep maintenance. You could take temazepam (Restoril) instead of lorazepam if you find it more helpful. I doubt you will find a doctor willing to prescribe triazolam, though.

Another option would be to take quetiapine (Seroquel).

Good luck.


- Scott

 

Re: Nardil(MAO) plus high dose stimulant/ Anyone? Stargazer2

Posted by SLS on June 17, 2020, at 8:15:40

In reply to Nardil(MAO) plus high dose stimulant/ Anyone?, posted by Stargazer2 on June 16, 2020, at 18:12:03

> So how do you explain what I went through? Have you ever had the hypertensive crisis related to a MAO and Ritalin?
> I would like to hear of all the others taking high dose stimulants plus a MAO and hear how many had reactions. I would not think there are many.
> As far as food goes yes you may not always have the reaction eating certain foods but can you say confidently you never will.
> I think this is one reason doctors will never order MAOs to anyone that doesnt have the ability to understand certain foods or drugs could kill you.
> What if I wasnt able to take my pressure or take the drug I did to lower my BP? Most would not have done what I did and the outcome could have been a stroke.

FWIW - I have taken high-dosage Parnate + desipramine + methylphenidate. I had absolutely no adverse reaction. Of course, that doesn't mean that you won't.


- Scott

 

Re: Nardil plus lorazepam/Jadde

Posted by Stargazer2 on June 17, 2020, at 8:35:02

In reply to Re: Nardil plus lorazepam Jadde, posted by SLS on June 17, 2020, at 8:12:30

Jade, I take Seroquel at night for sleep with Nardil. I think 50 maybe 25 mg. Lowest dose is best. No after effects for me. Works w/I 30 min.

 

Re: Nardil plus lorazepam/Jadde

Posted by Stargazer2 on June 17, 2020, at 8:35:10

In reply to Re: Nardil plus lorazepam Jadde, posted by SLS on June 17, 2020, at 8:12:30

Jade, I take Seroquel at night for sleep with Nardil. I think 50 maybe 25 mg. Lowest dose is best. No after effects for me. Works w/I 30 min.

 

Re: Nardil(MAO) plus high dose stimulant/SLS

Posted by Stargazer2 on June 17, 2020, at 8:50:41

In reply to Re: Nardil(MAO) plus high dose stimulant/ Anyone? Stargazer2, posted by SLS on June 17, 2020, at 8:15:40

What dose of Parnate? What dose and frequency of Ritalin?
Just need to be clear about that. I can take 5 mg Ritalin w/o a problem but Im tentative about taking more than 1-2/day out of fear. I would never take 10 mg again which caused my reaction. That was clearly related. It Happened w/I 5 min.
I also had a hypertensive reaction with Parmasean cheese so anyone saying these things are not gonna happen are In my personal opinion(and experience) minimizing a potential
Interaction. I know and have read about Gillmann. I have been reading about MAOs since my first one in 1987. I have taken all 3 plus Emsam.
My doctor would not have prescribed them without a strict warning about the potential for food/drug interactions.
As I said before pharmacies will not fill the order before speaking with the prescribing MD. Liability would fall on them. There are those people (Amateurs) who could take more than the prescribed dose of a stimulant (for a better effect) and get into trouble. The fear is already wired into my being having had it happen. No coincidental but consequential.

 

Re: Nardil plus lorazepam SLS

Posted by undopaminergic on June 17, 2020, at 12:29:17

In reply to Re: Nardil plus lorazepam Jadde, posted by SLS on June 17, 2020, at 8:12:30

> I would consider taking both zolpidem (short half-life for sleep initiation) and lorazepam (longer half-life for sleep maintenance) at bedtime. It is perfectly safe with Nardil (I do it).
>
> The most effective treatment that I know of for sleep is a combination of triazolam (Halcion) for sleep initiation and lorazepam (Ativan) for sleep maintenance. You could take temazepam (Restoril) instead of lorazepam if you find it more helpful. I doubt you will find a doctor willing to prescribe triazolam, though.
>
> Another option would be to take quetiapine (Seroquel).

I would be concerned about sleep quality with benzodiazepines. I forgot the details, but I think most benzos inhibit REM-sleep. In my personal experience, sleep on midazolam (Dormicum; a short-acting benzo like triazolam) was worthless. Z-drugs (eg. zolpidem) have less adverse effects on REM.

As for anti-histamines (like quetiapine), other options are cyproheptadine (Periactin), doxepin, and trimipramine (Surmontil); they last of them has been reported to increase REM-sleep.

> Good luck.
>

Much needed in psychopharmacology!

-undopaminergic

 

Re: Nardil plus lorazepam undopaminergic

Posted by SLS on June 17, 2020, at 12:36:50

In reply to Re: Nardil plus lorazepam SLS, posted by undopaminergic on June 17, 2020, at 12:29:17

UD - You are absolutely correct. Thanks for pointing that out.


- Scott


> I would be concerned about sleep quality with benzodiazepines. I forgot the details, but I think most benzos inhibit REM-sleep. In my personal experience, sleep on midazolam (Dormicum; a short-acting benzo like triazolam) was worthless. Z-drugs (eg. zolpidem) have less adverse effects on REM.
>
> As for anti-histamines (like quetiapine), other options are cyproheptadine (Periactin), doxepin, and trimipramine (Surmontil); they last of them has been reported to increase REM-sleep.
>
> > Good luck.
> >
>
> Much needed in psychopharmacology!
>
> -undopaminergic
>

 

Re: Nardil plus lorazepam (Trazodone?)

Posted by adiaphora on July 17, 2020, at 13:00:21

In reply to Re: Nardil plus lorazepam, posted by Stargazer2 on June 13, 2020, at 22:51:57

I did best with Trazodone for sleep with Nardil before I gave up on sleep aids because they lessened the anti-depressant and anti-anxiety effects of the MAOI. Trazodone had significantly fewer side effects (e.g., next-day grogginess, appetite stimulation) for me than Seroquel or benzos.


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