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Re: MAOI question for SLS

Posted by SLS on November 14, 2022, at 21:36:51

In reply to Re: MAOI question for SLS, posted by linkadge on November 14, 2022, at 14:50:02

> I wonder if there is a way to offset the REM suppression produced by MAOIs and whether this would abolish the AD effect.
> Interestingly, as I was transitioned off parnate and on to 50mg of seroquel, I felt controllably euphoric for about 2 weeks. I wonder if the sleep promoting effects of Seroquel enhanced the AD effect of parnate. I always wanted to try a parnate seroquel combination again.
> Linkadge

My guess is that your temporary euphoria was a rebound phenomenon for discontinuing Parnate. I have experienced a very sudden and significant antidepressant effect when discontinuing several agents. Parnate and Nardil both give me an improvement upon dosage increase *and* dosage decrease. I found myself running around in circles trying to find a stable response. Several tricyclics also gave me a temporary boost after I discontinued them. Imipramine and protriptyline produced the most noticeable rebound improvements.

I just want to reiterate that this last time around, I played a hunch with Nardil. Throughout my treatment history, *every* trial of Nardil produced as side effects hypotension to the point of almost passing out, and difficulties initiating urination / "urinary retention". This time, I played out my hunch and started low and increased the dosage gradually. (I might have said this already). I started at 7.5 mg/day for two weeks. Then 15 mg/day for two weeks. Thereafter, I increased by 15 mg/day every three weeks. No side effects. I thought that if I didn't trigger the side effects by overly-aggressively dosing, they might not emerge at all. Lucky guess. It's worth taking the extra time to avoid side effects that continue indefinitely.

Please take your time. You are much too sensitive to drug side effects or untoward mood / anxiety reactions. I would like to see you be as conservative with dosage increases as you feel comfortable with. You are easily spooked. That's not a criticism. Side effects can be worse than the depression. Be super-super slow if it keeps you from getting anxious. Use all of your psychological tricks to be patient and persistent. Preventing the emergence of side effects might make this trial a different experience for you altogether.

My conclusion:

The effective dosage range for Nardil is 60-90 mg/day. Almost no one responds to 45 mg/day. I would say that 75 mg/day is the most common bullseye.

If you have any questions or would like us to be a 2-man think tank, please Babblemail me. You might be surprised to know how badly I have wanted to see you to get well over all of these years. I think our frustrations with each other in the past was likely a reflection of our frustration with the disease.

Yes. I do have survivors guilt.

- 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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