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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by porkpiehat on November 20, 2017, at 12:06:58
I'm finding that Marplan alone is not enough to tackle my anxiety and, to some degree, social apathy. I've stopped taking trazodone for sleep, as I find it has wonky effects the next day, including some irritability. So I also need something for sleep.
When I took gabapentin at night, I found my neurosis seriously decreased--allowing me to feel more open and connected--but it did produce some weakness, confusion and fogginess for the first part of the next day. I'm wondering if pregabalin would have less cognitive effects and last longer? I think it decreases glutamine release, as does the lamictal I take.
The other choice would be Nortriptyline, hoping that it would reduce anxiety and address daytime sedation through its NE reuptake inhibition...I've heard that it can offset some anhedonia. Not sure how it would do for sleep alone, or if it could be combined with other 5ht2a antagonists like hydroxyzine for sleep.
I was taking wellbutrin for a couple of days and it really helped re-engage with poeple and engage in my interractions more. But it was making a little manic and adding to anxiety at times. Maybe clonidine would help that. For now I've stripped away all my add-ons except Marplan and Lamictal to gauge their effects alone. Bad sleep was catching up to me.
does anyone have experiences to report with either of these combinations? Thanks in advance?
Posted by Christ_empowered on November 20, 2017, at 13:09:23
In reply to Pregabalin vs Nortriptyline as MAOI add on?, posted by porkpiehat on November 20, 2017, at 12:06:58
id personally opt for the pregabalin over an additional antidepressant, especially w/ ongoing MAOI treatment...but that's just me.
Lyrica is (I think...) dosed 2x daily, vs 3x daily for gabapentin. I seem to recall reading that long-term use is associated w/ a benzodiazepine-type discontinuation syndrome, but...I would think/assume that a very slow, careful taper would minimize problems with stopping treatment.
good luck.
Posted by PeterMartin on November 21, 2017, at 2:17:43
In reply to Re: Pregabalin vs Nortriptyline as MAOI add on?, posted by Christ_empowered on November 20, 2017, at 13:09:23
Does Trazadone increase serotonin? Pretty sure it acts as an SSDRNI or whatever they call it (all 3). With an maoi you could end up w s.syndrome.
I use just 25mg of Seroquel for sleep. Knocks me out every night and has been for 10yrs or so...no tolerance, no weight gain, just knocks me out
Posted by porkpiehat on November 21, 2017, at 8:23:24
In reply to Re: Pregabalin vs Nortriptyline as MAOI add on?, posted by PeterMartin on November 21, 2017, at 2:17:43
A lot of these precautions are outdated and don't consider the actual mechanisms of the drug. At lower doses, Nortriptyline and doxepin (as well as most of the TCA's) and trazodone are not releasers or Reuptake inhibitors of SE, and antagonizers of multiple SE receptors. They are considered helpful add-ons.
Posted by baseball55 on November 22, 2017, at 17:57:51
In reply to Re: Pregabalin vs Nortriptyline as MAOI add on? » PeterMartin, posted by porkpiehat on November 21, 2017, at 8:23:24
I take 100-200mg trazadone most nights and also take 30mg/day parnate. Pharmacy at first required my p-doc to sign off on the combination, which he did. I've never had a problem in five years.
This is the end of the thread.
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