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Re: history and pharmacists » Elizabeth

Posted by SLS on June 3, 2000, at 9:26:37

In reply to history - Jennifer, posted by Elizabeth on June 3, 2000, at 7:50:15

> > Mirapex does lower your blood pressure though, and since Nardil was originally for lowering blood pressure (and then when everyone was in a good mood, they found a new use for it!) you may get a double whammy of low b/p.

> There was an MAOI - Eutonyl (pargyline) - that popped up at some point and was used as an antihypertensive, but it's no longer available AFAIK.

I don't think pargyline is terribly effective as an antidepressant. One reason may be that it is fairly selective for MAO-B. An interesting lessen in trying to infer drug activities based upon molecular heritage (not that you need one) is that a propargyl cousin of pargyline, deprenyl is also selective for MAO-B, while another cousin, clorgyline, is specific for MAO-A.

> BTW, I wouldn't necessarily trust anything a pharmacist said about MAOIs. IME, they tend to get a lot of things wrong, especially in regard to interactions; I pretty much feel I can count on them to parrot the PDR (though there are exceptions). I attribute this to a lack of real clinical experience.

Except for Cam W. :-)


Dear Elizabeth,

Does Mirapex, or any of the other DA agonists, potentiate the hypotensive effect of Nardil or any of the other MAOIs? I didn't experience this when I added Parlodel to Parnate + desipramine.

Oh, and while I've got you here, I'm having trouble deciding whether to use Nardil or Parnate for treating my bipolar depression. I am aware of the traditional choice of Parnate in this situation. However, having experienced a partial response to both, I like the way I feel on Nardil better. It is becoming increasingly apparent that anhedonia can persist in many people who otherwise respond robustly to Parnate. A confounding factor is that I will be using a tricyclic along with either MAOI. I experience one hell of a synergism between Nardil and a tricyclic with regard to hypotension and the ability to initiate urination. Imipramine is out, although it is probably more effective. I will be using desipramine, and will be throwing in as much other crap as I can find.

Any suggestions?

Any opinions on Gabitril?

What is your gut-reaction to Tegretol?


I will be eternally grateful if you would be kind enough to cure me.


Sincerely,
Scott

 

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