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Re: any experience/knowledge of augmenting MAOI's??

Posted by John D. on January 4, 2001, at 16:31:09

In reply to Re: any experience/knowledge of augmenting MAOI's?? » JohnM, posted by shellie on October 15, 2000, at 15:45:18

> > I presently take Nardil. It worked well for me years ago, but not so much lately. Any input would be appreciated. John
> John, I wrote the following post a couple of months ago to someone else who answered the same question, so I thought I'd copy it here for you:
> >I'm going to give you all the information that I gathered since January, when I felt the nardil lost effectiveness, since some part of it may be helpful to you. I'll try to condense.
> In Feb did a trial of sam-e with Nardil, with on the phone supervision with a physician affiliated with Columbia U. who wrote a book on sam-e. He gave sam-e a 70% change of working. Unfortunately, it was not good for me--it made me more depressed and very agitated. But if you look at the sam-e board at a lot of people who had tried lots of prescription meds, had enormous success with it.
> He also said if the sam-e didn't work, these would be his recommendations to try with nardil:
> 1. thyroid, add 25 mc of cytomel (t3) for 2 weeks; can try 37.5 also
> ***2. lamcital- (anti-seizure medication) have to go up very very slowly„over a 3 month period--
> 3. add very low lithium level (works 50% of time)„
> 4. add traxedone (deserel)
> 5. add pindolol
> 6. add ridlin or dexadrine or adderall
> Because my pdoc was unwilling to experiment, I also consulted with a pdoc at NIMH by phone (very helpful) and with my old pdoc, who was no longer
> accepting my insurance.
> The first choice of all three was lamictal. In the last" MAOI doesn't work anymore" thread, I explained that lamictal worked for me really well, but I was gaining weight. A very small percent of people gain weight on lamictal. I was unlucky and unwilling to accept a weight gain since there were other things for me to try. But I think it is very significant that all three doctors I consulted with, picked that as their first choice. >
> Anyway, since that post I've tried the following augmentors with nardil (all unsuccessfully)
> aricept
> naltrezone
> provigal
> topmax
> stimulents: ritalin, dexadrine
> resperadone speech slurred)
> amisulpride french anti-psychotic
> adrafinil (french stimulent-had seratone reaction with combination--I don't recommend).
> After getting off of nardil and trying serzone, I am now back on nardil and am adding some serzone. If I were you, my first choice would be lamictal, since it was recommended for me to try independently by three different doctors and it worked. (And very few people gain weight on it). Or deseral.
> Good luck, hope I didn't overwhelm you. Shellie
> I have been experiencing a parital relief of depressive symptoms with Nardil ever since I have been taking it (@90mg/d). Although this was initially satisfactory, I have found it very difficult to maintain a normal life at my present level of mental health. Although I get along with my pdoc very well, he has made it clear to me that he doesn't get involved with MAOI polypharmacy. When I related this situation to another mental health pro, he suggested I go out of town for my treatment (he stated that it was unlikely I would be able to find anyone in town who would do differently than my pdoc). I then asked my primary MD to make an appointment for me at a university's medical school. I was informed the pdoc I requested to see was retired. I would still like to see someone who is experienced with treatment-resistant depression, but my inquiries in this direction have been less than fruitful. I loathe to make an appointment based on a haphazard approach, but I'm not sure where to go next. BTW, how do phone consultations work? I saw a posting regarding one with a pdoc @ the NIMH, and I think it could be worth a try.




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