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Re: remission )) Thank you Jay! Roslynn

Posted by SLS on September 22, 2022, at 18:25:31

In reply to Re: remission )) Thank you Jay!, posted by Roslynn on September 22, 2022, at 14:41:47

Hi, Roselynn.

A few more thoughts.

1. Abilify: The anxiety you reported while taking Abilify might have been akathisia. Akathisia is dosage-dependent and can be triggered by overly aggressive dosing at the beginning of treatment. The dosage of Abilify optimal for treating depression is usually very low: 2-5 mg/day.

What dosage of Abilify were you started at?
What dosage of Abilify did you arrive at?
At what dosage of Abilify did the anxiety / akathisia emerge?
How long did you take Abilify for?
Did you feel any improvement in depression at all?

2. Have you taken any of the following tricyclic antidepressants?
- imipramine (Tofranil)
- desipramine (Norpramin)
- amitriptyline (Elavil)
- nortryptyline (Pamelor)
- clomipramine (Anafranil)

3. If your depression has a bipolar diathesis (like mine), perhaps you need to take a combination of MAOI + TCA (like I do). Maybe? It might be worth a try if you can get a doctor to research the efficacy and safety of this treatment.

Allowed MAOIs: Nardil, Parnate, Marplan.

Allowed TCAs: Desipramine, Nortryptyline

Probably safe TCAs: Amitriptyline, Doxepin, Trimipramine.

Dangerous TCAs: Imipramine, Clomipramine

In general, MAOIs cannot be combined with any drug that has as one of its properties the inhibition of the reuptake of serotonin. This is probably true drugs that increase serotonin release as well.

SSRIs (Prozac, Zoloft, Paxil, Celexa, Lexapro)

SNRIs (Effexor, Pristiq, Cymbalta, milnacipran, levomilnacipran)

Other contraindicated serotonergic drugs include fenfluramine, dexfenfluramine, tramadol, sibutramine, dextromethorphan, phenylpiperidine, methadone, levorphanol, and several opioids.

Between the no-tyramine diet and the drug contraindications, it looks pretty scary at first look. However, avoiding foods containing tyramine and drugs that are pro-serotonergic has not been terribly inconvenient.

- Scott

Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.




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