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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by iforgotmypassword on September 26, 2005, at 16:35:59
i've had it. i am now at desipramine 50mg, and it never helped if i went any higher... now i will add parnate 10mg, and add another 10-20mg every 2-3 days. hopefully i will get some effect not in the form of a hypertensive crisis. sound like a plan? i will keep everyone posted if i get any benefit.
i may want to consider an NMDA antagonist in the future, but i don't know whats available in canada, and am not exactly sure how i would con a prescription out of a doctor... i guess ill have to grab whatever i can find from pubmed or the psycinfo database if any journal articles have ever been published regarding its use.
Posted by Tom Twilight on September 27, 2005, at 15:55:34
In reply to starting parnate + desipramine, posted by iforgotmypassword on September 26, 2005, at 16:35:59
Hey Password
I wish you luck with this combo
Adding Desipramine to an MAOI is one of those classic combinations.
Its also one of the safest MAOI augments (I think).Desipramine has almost no effect on Seratonin so theres hardly any chance of Seratonin syndrome.
Regarding hypertensive crisi's I think Desipramine might decrease the chance of having one rather than increasing it.
I know this seems counter intuitive, but Noradrenaline re-uptake inhibitors can actually prevent Hypotension, although I'm not quite sure of the mechanism.
I've seen studies were Amytriptaline and Reboxetine helped prevent the build up of TyramineHeres a study
Reboxetine prevents the tranylcypromine-induced
increase in tyramine levels in rat heart
by
Dostert P, Castelli MG, Cicioni P, Strolin Benedetti M
Farmitalia Carlo Erba,
Research and Development,
Erbamont Group, Milan, Italy.
J Neural Transm Suppl 1994; 41:149-53ABSTRACT
This study aimed to examine whether the increase in heart radioactivity levels after intravenous injection of 14C-tyramine to rats pretreated with the irreversible MAO inhibitor tranylcypromine could be antagonized by reboxetine, a potent and selective noradrenaline uptake blocker. Reboxetine was found totally to abolish the effect of tranylcypromine. Heart radioactivity levels after reboxetine and tranylcypromine were very similar to those found when tyramine was injected after reboxetine only. These results suggest that reboxetine might be advantageously combined with tranylcypromine, or any MAO inhibitor, in depressed patients unresponsive of either treatment given alone.
This is the end of the thread.
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