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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by willyee on March 21, 2005, at 6:58:36
OOPS sorry this should have posted before the one after with the link,see what happens when u try to have messagner open with people doing that annoying BUZZ and scaring the hell out of me,here is my post....
I once had the tca amitriptyline from a friend who dident use them.I hadent plan on using them,but she told they put her to sleep,so i took it just in case.Well in one of my many parnate times when it seemed it was totaly ineffective,i took the amitriptyline during the day.I remeber having a great ant-idepressant response,but had no more pills to be sure,plus i wasnt thinking that might have been why.
I remembered what i took,and now am waiting on a order of amitriptyline any day now.I want to be careful,and i think its funny that i came across this information regarding the two.......
"This is an approximate order of potency. Iproniazid is seldom used now because of the increased risk of hepatotoxicity. Tranylcypromine is the most likely to cause a 'cheese reaction and isocarboxazid the least. An important paper in The lancet, from St. Bartholomew's Hospital, (Pare et al., l982) described the safety and efficacy of combining amitriptyline (Tryptizol) and tranylcypromine (Parnate) - If the patient was on tranylcypromine alone, the rise in blood pressure produced by tyramine1 the dangerous ingredient in cheese, was substantial. The rise in blood pressure was less following a tyramine injection when the patient was on amitriptyline and tranylcypromine. The safety and efficacy of this combination was demonstrated in a controlled trial from the University of Southern California (Raaani et al, 1983) - The other antidepressants investigated at Barts in combination with tranylcypromine were trimipramine (Surmontil) and dothiepin (Prothiaden). They did not confer the same degree of protective effect as amitriptyline.
In summary, it is safer to use tranylcypromine combined with amitriptyline than tranylcypromine alone. Even on this combination however, dietary restriction and an MAOI card are essential. Certain MAOI + tricyclic combinations eg. with clomipramine (Anafranil) or imipramine (Tofranil) are potentially lethal and should never be used. The use of combined antidepressants is complicated and should be restricted to those who are familiar with it."
I can attest for imipramine,they went horrable when the too were even close in my system by date,so on two factors this article is right in my account.So im curious if anyone had any experieance on using these two specific meds togther,but only these not a third such as a mood stablizer,if so id love to hear ur response.I think parnate is very very suspectable to any addition of another drug,more so than ur common meds,so adding a ani anxiety med or stablizer affects parnate efficancy to a much higher and significant degree than simply adding it to the newer genration ones.
Posted by Maxime on March 21, 2005, at 14:24:26
In reply to Parnate augment, posted by willyee on March 21, 2005, at 6:58:36
How much amitriptyline should be used to augment the Parnate?
Maxime
> OOPS sorry this should have posted before the one after with the link,see what happens when u try to have messagner open with people doing that annoying BUZZ and scaring the hell out of me,here is my post....
>
>
> I once had the tca amitriptyline from a friend who dident use them.I hadent plan on using them,but she told they put her to sleep,so i took it just in case.
>
> Well in one of my many parnate times when it seemed it was totaly ineffective,i took the amitriptyline during the day.I remeber having a great ant-idepressant response,but had no more pills to be sure,plus i wasnt thinking that might have been why.
>
> I remembered what i took,and now am waiting on a order of amitriptyline any day now.I want to be careful,and i think its funny that i came across this information regarding the two.......
>
>
> "This is an approximate order of potency. Iproniazid is seldom used now because of the increased risk of hepatotoxicity. Tranylcypromine is the most likely to cause a 'cheese reaction and isocarboxazid the least. An important paper in The lancet, from St. Bartholomew's Hospital, (Pare et al., l982) described the safety and efficacy of combining amitriptyline (Tryptizol) and tranylcypromine (Parnate) - If the patient was on tranylcypromine alone, the rise in blood pressure produced by tyramine1 the dangerous ingredient in cheese, was substantial. The rise in blood pressure was less following a tyramine injection when the patient was on amitriptyline and tranylcypromine. The safety and efficacy of this combination was demonstrated in a controlled trial from the University of Southern California (Raaani et al, 1983) - The other antidepressants investigated at Barts in combination with tranylcypromine were trimipramine (Surmontil) and dothiepin (Prothiaden). They did not confer the same degree of protective effect as amitriptyline.
>
>
>
> In summary, it is safer to use tranylcypromine combined with amitriptyline than tranylcypromine alone. Even on this combination however, dietary restriction and an MAOI card are essential. Certain MAOI + tricyclic combinations eg. with clomipramine (Anafranil) or imipramine (Tofranil) are potentially lethal and should never be used. The use of combined antidepressants is complicated and should be restricted to those who are familiar with it."
>
>
> I can attest for imipramine,they went horrable when the too were even close in my system by date,so on two factors this article is right in my account.So im curious if anyone had any experieance on using these two specific meds togther,but only these not a third such as a mood stablizer,if so id love to hear ur response.
>
> I think parnate is very very suspectable to any addition of another drug,more so than ur common meds,so adding a ani anxiety med or stablizer affects parnate efficancy to a much higher and significant degree than simply adding it to the newer genration ones.
>
>
Posted by Maxime on March 21, 2005, at 14:52:08
In reply to Parnate augment, posted by willyee on March 21, 2005, at 6:58:36
I wonder if I could safely add desipramine to my Parnate? Does anyone know? I combined it with Surmontil and nothing exciting happened. 10 mg of Amitriptyline knocks me out cold. The Surmontil does as well. If I take it at night I can't wake for up for about 10 hours or more.
I saw a psychopharmacologist for a while who wanted me to combined amitriptyline with my prozac. He wanted me to get up to 100 mg of amitriptyline. Well since I couldn't get past 10 mg that plan went out the window. He gave up on me then. He wasn't that bright ...
So Ed? Do you know if it can be done. Of course I would ask my pdoc for permission.
Funny, desipramine isn't suppose to be sedating, but it is for me. Hum.
Any input would be greatly appreciated.
MAxime
Posted by ed_uk on March 21, 2005, at 15:08:16
In reply to Re: Parnate augment - desipramine ????, posted by Maxime on March 21, 2005, at 14:52:08
Hi Maxime :-)
>I wonder if I could safely add desipramine to my Parnate? Does anyone know?
Some people do combine them, SLS used to take this combination. The risk of serotonin syndrome should be low because desipramine is only a very weak serotonin reuptake inhibitor.
>Funny, desipramine isn't suppose to be sedating, but it is for me.
Did you start at 10mg and gradually increase? Did you take it at night? I expect the sedation would wear off quite fast. Desipramine is a weak antihistamine, tolerance to the drowsiness should develop in a week or two.
Ed xxxxxxxxxxxxxx
Posted by SLS on March 21, 2005, at 17:35:54
In reply to Re: Parnate augment - desipramine ???? SLS » Maxime, posted by ed_uk on March 21, 2005, at 15:08:16
> Hi Maxime :-)
>
> >I wonder if I could safely add desipramine to my Parnate? Does anyone know?
>
> Some people do combine them, SLS used to take this combination. The risk of serotonin syndrome should be low because desipramine is only a very weak serotonin reuptake inhibitor.Parnate seems to be very forgiving as an MAOI. You can definitely add desipramine to it safely. Your doctor might want to go very slow in the beginning, but that would be his prerogative. If he has never done it before, you can't blame him. I found that you can titrate desipramine with Parnate just as quickly as you can without it. Going up 25mg at a time seems prudent.
Do you think your doctor will go for it?
- Scott
Posted by willyee on March 21, 2005, at 17:39:02
In reply to Re: Parnate augment, posted by Maxime on March 21, 2005, at 14:24:26
I only have the link and my exper to refer to.The link i gave,and it doesent state the dose i believe,i do know the article say that the Maoi should be lowered in dosage if you are to combine it,did you get a chance to read the entire article,most stuff is common,but still a good read.
I personaly used 10 mg of amtrip,and thats really all i will use,i just need something to provide a relax factor,even when parnate is tiring its acitvating,can anyone say they are able to sit and enjoy a peacful evening on it?
Id like to keep the parnate dose low,so its more stimulating than tiring,and add a med to calm me with having to loose the parnate effect,this is my goal.Benzos and such have not worked,for whatever reason they dont seem to have a great synergy with parnate,ill keep ya posted all.
Posted by Maxime on March 21, 2005, at 21:36:19
In reply to Re: Parnate augment - desipramine ???? SLS, posted by SLS on March 21, 2005, at 17:35:54
My doctor is at the point where he doesn't know what to do with me. I think he will let me try. He let me take Adderall with 80 mg of Parnate.
I just don't know what dosage of Parnate I would go to and the same with the desipramine. If I keep my dosage of Parnate at 80 mg then would I be able to take (work up to)say 50 mg of the desipramine? I don't know.
I am worried that I am so out of it now that I won't be able to handle the desipramine because it is sedating for me. But then again, I could just lay in bed all day and wait for the end to come. That's what I feel like doing. Never eating another thing and just starving myself to death.
I'm at the point where I NEED my pdoc to tell me what to do. If it weren't for you guys I would be up a creek because I can't research these things on my own right now.
Sorry for such a long winded answer to a simple question.
Yes, I think he would let me take them together.
Maxime
> > Hi Maxime :-)
> >
> > >I wonder if I could safely add desipramine to my Parnate? Does anyone know?
> >
> > Some people do combine them, SLS used to take this combination. The risk of serotonin syndrome should be low because desipramine is only a very weak serotonin reuptake inhibitor.
>
> Parnate seems to be very forgiving as an MAOI. You can definitely add desipramine to it safely. Your doctor might want to go very slow in the beginning, but that would be his prerogative. If he has never done it before, you can't blame him. I found that you can titrate desipramine with Parnate just as quickly as you can without it. Going up 25mg at a time seems prudent.
>
> Do you think your doctor will go for it?
>
>
> - Scott
Posted by Maxime on March 21, 2005, at 22:49:39
In reply to Re: Parnate augment - desipramine ???? SLS, posted by SLS on March 21, 2005, at 17:35:54
>
> Parnate seems to be very forgiving as an MAOI.A little too forgiving. You can take 5000 mg and survive. Sad but true fact.
Maxime
This is the end of the thread.
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