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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by PhoenixGirl on January 22, 2004, at 23:53:15
I have a long, long history of antidepressant failures, and want to try Parnate. I have not tried MAOI's. Problem is, I take several other meds, and my pdoc doesn't want to even try adding Parnate while reducing the other stuff. She would want me completely off my other stuff for 2 full weeks before starting me on Parnate. Problem is, I can't be off antidepressants or I become so depressed and tired that I can't function.
I take Strattera, Provigil, Lamictal, Wellbutrin SR, and Klonopin. All at regular doses, not low or high doses. I've read that very skilled pdocs can start a person on an MAOI while they are still on other meds. I would need to slowly increase an MAOI while decreasing the other stuff.
Is it possible for me to try an MAOI, given the above circumstances?
Posted by cubbybear on January 23, 2004, at 0:59:33
In reply to Possible to start an MAOI while on other meds??, posted by PhoenixGirl on January 22, 2004, at 23:53:15
Hi,
Hope this will be of some help. It's great that you're going to give Parnate a try. I've considered this drug to be a lifesaver for about 20 years now.But there are a number of other meds out there--such as SSRIs, Wellbutrin, and Effexor-- that you definitely can NOT take while on MAOIs. You definitely CAN take a benzo drug such as Klonopin or Xanax. I've been doing that and these can actually solve the problem of insomnia that Parnate can cause in some people.
Sorry, I don't know anything about the other drugs you mentioned, but be sure you get a definitive yes or no before starting the Parnate.
Posted by SLS on January 23, 2004, at 8:16:36
In reply to Re: Possible to start an MAOI while on other meds?? » PhoenixGirl, posted by cubbybear on January 23, 2004, at 0:59:33
That's a lot of drugs to be messing with in conjunction with Parnate. Any one of them can be combined safely with an MAOI, even Wellbutrin. However, it would be guess work and a gamble to assume safety when all of these drugs are combined. Actually, I haven't seen anyone mix Strattera with a MAOI, so I'm not even sure about that. You could perhaps stay on the Wellbutrin and Klonopin, and add Provigil later if necessary.
- Scott
Posted by gardenergirl on January 23, 2004, at 10:02:35
In reply to Re: Possible to start an MAOI while on other meds?? » PhoenixGirl, posted by SLS on January 23, 2004, at 8:16:36
One word of caution. I believe that combining other medications with MAOI's is best done under a physician's close supervision, ideally one who is comfortable and familiar with MAOI's. I know if it were me I would want to be reassured that risks of interactions were minimized.
That being said, I wish you the best of luck in finding something that will work for you.
gg
Posted by Maxime on January 23, 2004, at 15:22:52
In reply to Possible to start an MAOI while on other meds??, posted by PhoenixGirl on January 22, 2004, at 23:53:15
You would probably have to go off the Wellbutrin, strattera, provigil. The lamictal and klonopin would be OK. You would be able to add the provigil afterwards if you need it.
It's important that you go off these meds so that you don't have a bad reaction. Also, you need to know if the Parnate is working. If it is going to be too much trouble for you, you might consider going inpatient while the change over is done.
Maxime
> I have a long, long history of antidepressant failures, and want to try Parnate. I have not tried MAOI's. Problem is, I take several other meds, and my pdoc doesn't want to even try adding Parnate while reducing the other stuff. She would want me completely off my other stuff for 2 full weeks before starting me on Parnate. Problem is, I can't be off antidepressants or I become so depressed and tired that I can't function.
> I take Strattera, Provigil, Lamictal, Wellbutrin SR, and Klonopin. All at regular doses, not low or high doses. I've read that very skilled pdocs can start a person on an MAOI while they are still on other meds. I would need to slowly increase an MAOI while decreasing the other stuff.
> Is it possible for me to try an MAOI, given the above circumstances?
Posted by djmmm on January 26, 2004, at 22:36:43
In reply to Possible to start an MAOI while on other meds??, posted by PhoenixGirl on January 22, 2004, at 23:53:15
> I have a long, long history of antidepressant failures, and want to try Parnate. I have not tried MAOI's. Problem is, I take several other meds, and my pdoc doesn't want to even try adding Parnate while reducing the other stuff. She would want me completely off my other stuff for 2 full weeks before starting me on Parnate. Problem is, I can't be off antidepressants or I become so depressed and tired that I can't function.
> I take Strattera, Provigil, Lamictal, Wellbutrin SR, and Klonopin. All at regular doses, not low or high doses. I've read that very skilled pdocs can start a person on an MAOI while they are still on other meds. I would need to slowly increase an MAOI while decreasing the other stuff.
> Is it possible for me to try an MAOI, given the above circumstances?Discuss it with your Dr...it really depends on the half-lives of the strattera and wellbutrin, and Provigil...
I would say, a few days would be perfectly safe (but Im not a dr.) A skilled Psychiatrist would consult a variety of professional sources before giving the "2 week washout" speech.
It would be inadvisable to ADD a MAOI to that combo (although, some docs slowly ADD MAOIs to certain TCAs)... You should be OFF the other meds before starting Parnate...the question you should be asking your doc is "Will the 2 week washout period be more dangerous than being clinically depressed and OFF medication for that time?"
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