![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 48 to 72 of 82. Go back in thread:
Posted by rose45 on April 3, 2022, at 12:19:46
In reply to Re: combining nardil and parnate ) SLS » rose45, posted by SLS on April 1, 2022, at 20:09:36
Im still alive, Scott. Thank you for asking, but totally suicidal, although I dont think I will ever do it. But cant face however many years are left for me to live in this state. My memory is practically non existent,
and I can't do the simplest of things but Im afraid to come off the lamotrigine which I know is the culprit as I tried, and the depression and anxiety got so much worse. NHS want me to add lithium. I already am unable to come off tcp,lamotrigine and olanzapine.Is there any hope for me? I just cannot see any.
Posted by rose45 on April 4, 2022, at 9:54:26
In reply to Re: combining nardil and parnate ) SLS » rose45, posted by SLS on April 1, 2022, at 20:09:36
> Hi, Rose.
>
> > > A "bridge" is meant to be a temporary treatment to mitigate any suffering that occur during a washout period.
> > >
> > > For me, I think there are 2 drugs that make good candidates tor being a bridges.
> > >
> > > 1. Zyprexa (olanzapine)
> > > 2. Saphris (asenapine)
> > >
> > > Although Abilify (aripiprazole) might work well to mitigate an antidepressant withdrawal syndrome, discontinuing it is problematic and produces anxiety as its own withdrawal syndrome.
> > >
> > >
> > > - Scott
> >
> > Isn't Olanzapine also very difficult to come off?
>
>
> That's a good point. I have not had a problem with olanzapine discontinuation the few time I took it. Maybe I just got lucky. Is anxiety a withdrawal symptom of olanzapine discontinuation?
>
> I don't think I ever asked you how you were feeling.
>
> Don't worry, I won't start now...
>
> Silliness aside, are you hanging in there?
>
>
> - ScottIm hanging in there but in a very bad way. The NHS want to add lithium. From what I gather from your posts, lithium is not an essential part of your recovery ?
Do you think it can kick-start the tcp which is no longer working ? Lamotrigine did kick start it many months ago, but then stopped working and has now completely destroyed my memory and Im finding it very hard to come off it. In fact, Im finding it impossible to come off tcp, or lamotrigine or olanzapine. Just dont know what to do.
Posted by undopaminergic on April 4, 2022, at 10:24:05
In reply to Re: combining nardil and parnate ) SLS » SLS, posted by rose45 on April 4, 2022, at 9:54:26
> Do you think it can kick-start the tcp which is no longer working ? Lamotrigine did kick start it many months ago, but then stopped working and has now completely destroyed my memory and Im finding it very hard to come off it. In fact, Im finding it impossible to come off tcp, or lamotrigine or olanzapine. Just dont know what to do.
>
>It sounds like it can't get much worse, or I wouldn't ask, but have you ever tried psychedelics?
-undopaminergic
Posted by Lamdage22 on April 4, 2022, at 11:33:25
In reply to Re: combining nardil and parnate ) SLS » SLS, posted by rose45 on April 4, 2022, at 9:54:26
Rose, Lithium can calm your suicidal thoughts down quite a bit. Can you get low dose? I am on 225. I recall SLS thinks it is essential for him too. Few side effects at low dose. Hope this helps.
Posted by Lamdage22 on April 4, 2022, at 11:36:37
In reply to Re: combining nardil and parnate ) SLS » SLS, posted by rose45 on April 4, 2022, at 9:54:26
What is tcp?
Posted by rose45 on April 4, 2022, at 11:49:47
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 4, 2022, at 11:33:25
> Rose, Lithium can calm your suicidal thoughts down quite a bit. Can you get low dose? I am on 225. I recall SLS thinks it is essential for him too. Few side effects at low dose. Hope this helps.
I will try to limit it to low dose, even if they dont agree..... Why are you taking it ?
But my main problem is this dreadful anxiety, which used to be covered up by the tcp when it was working. Not sure if lithium can help with anxiety?
Posted by Lamdage22 on April 4, 2022, at 12:27:49
In reply to Re: combining nardil and parnate ) SLS » Lamdage22, posted by rose45 on April 4, 2022, at 11:49:47
Specifically against suicidal thoughts. And for neuroprotection. It is basically a mineral. You'll find it in water in varying conncentrations. Not sure about anxiety, maybe not as much. But suicidal thoughts hurt. At least me.
> I will try to limit it to low dose, even if they dont agree..... Why are you taking it ?
> But my main problem is this dreadful anxiety, which used to be covered up by the tcp when it was working. Not sure if lithium can help with anxiety?
Posted by Lamdage22 on April 4, 2022, at 12:32:43
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 4, 2022, at 12:27:49
I like liposomal GABA for anxiety. It is a version of GABA that crosses the blood brain barrier. There is a product that also has Theanine in it. It doesn't hurt. I can't sleep without it.
https://www.quicksilverscientific.com/all-products/gaba-l-theanine/Not getting any money from them. You guys know I'm real.
Posted by undopaminergic on April 4, 2022, at 12:33:50
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 4, 2022, at 11:36:37
> What is tcp?
TranylCyPromine. Or Transmission Control Protocol (which gets used every time you access a web site).
-undopaminergic
Posted by Lamdage22 on April 4, 2022, at 12:35:49
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 4, 2022, at 12:32:43
Is there any history of psychosis or mania? If so, caution with psychedelics or stimulants. Thats just my cents.
Posted by Lamdage22 on April 4, 2022, at 12:42:04
In reply to Re: combining nardil and parnate ) SLS, posted by undopaminergic on April 4, 2022, at 12:33:50
> > What is tcp?
>
> TranylCyPromine. Or Transmission Control Protocol (which gets used every time you access a web site).
>
> -undopaminergicProbably the former in this context.
Posted by SLS on April 4, 2022, at 13:22:53
In reply to Re: combining nardil and parnate ) SLS » SLS, posted by rose45 on April 4, 2022, at 9:54:26
Hi, Rose.
> >
> > I don't think I ever asked you how you were feeling.
> >
> > Don't worry, I won't start now...
> >
> > Silliness aside, are you hanging in there?
> >
> >
> > - Scott> Im hanging in there but in a very bad way. The NHS want to add lithium. From what I gather from your posts, lithium is not an essential part of your recovery ?
.
No!
Lithium *is* essential for me!
However, lithium produces an antidepressant effect for me *only* at 300 mg/day. Once I increase the dosage to 450 mg/day, I begin to deteriorate. It's amazing. I found some literature that suggests an explanation for this. Lithium demonstrates a bimodal effect on both glutamate neurotransmission and clinical response.
> Do you think it can kick-start the tcp which is no longer working ? Lamotrigine did kick start it many months ago, but then stopped working and has now completely destroyed my memory and Im finding it very hard to come off it. In fact, Im finding it impossible to come off tcp, or lamotrigine or olanzapine. Just dont know what to do.
I have responded best to Parnate when it was combined with either desipramine or nortriptyline.- Scott
Posted by SLS on April 4, 2022, at 13:27:01
In reply to Re: combining nardil and parnate ) SLS » SLS, posted by rose45 on April 4, 2022, at 9:54:26
Hi, Rose.
> >
> > I don't think I ever asked you how you were feeling.
> >
> > Don't worry, I won't start now...
> >
> > Silliness aside, are you hanging in there?
> >
> >
> > - Scott> Im hanging in there but in a very bad way. The NHS want to add lithium. From what I gather from your posts, lithium is not an essential part of your recovery ?
.
No!
Lithium *is* essential for me!
However, lithium produces an antidepressant effect for me *only* at 300 mg/day. Once I increase the dosage to 450 mg/day, I begin to deteriorate. It's amazing. I found some literature that suggests an explanation for this. Lithium demonstrates a bimodal effect on both glutamate neurotransmission and clinical response.
> Do you think it can kick-start the tcp which is no longer working ? Lamotrigine did kick start it many months ago, but then stopped working and has now completely destroyed my memory and Im finding it very hard to come off it. In fact, Im finding it impossible to come off tcp, or lamotrigine or olanzapine. Just dont know what to do.
I have responded best to Parnate when it was combined with either desipramine or nortriptyline.If you have never tried Nardil, I strongly encourage you to do so. It is much better for anxiety than is Parnate. For me, Nardil makes me feel much "brighter" than Parnate. Nardil is also "pro-social". I did not find Parnate capable of doing this, even when it produced a remission of depression.
- Scott
Posted by Lamdage22 on April 4, 2022, at 13:36:59
In reply to Re: combining nardil and parnate ) SLS » rose45, posted by SLS on April 4, 2022, at 13:27:01
I can second that.
> If you have never tried Nardil, I strongly encourage you to do so. It is much better for anxiety than is Parnate. For me, Nardil makes me feel much "brighter" than Parnate. Nardil is also "pro-social". I did not find Parnate capable of doing this, even when it produced a remission of depression.
Posted by Lamdage22 on April 4, 2022, at 13:53:48
In reply to Re: combining nardil and parnate ) SLS » rose45, posted by SLS on April 4, 2022, at 13:27:01
It has cool pro GABA effects. In a way that is more sustainable and less addicting than Benzos.
Posted by Lamdage22 on April 4, 2022, at 13:56:17
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 4, 2022, at 13:53:48
If I could, Id like just the GABAergic effect and not the MAO Inhibition. That got me in a problematic state.
Posted by rose45 on April 4, 2022, at 17:42:26
In reply to Re: combining nardil and parnate ) SLS » rose45, posted by SLS on April 4, 2022, at 13:27:01
> Hi, Rose.
>
> > >
> > > I don't think I ever asked you how you were feeling.
> > >
> > > Don't worry, I won't start now...
> > >
> > > Silliness aside, are you hanging in there?
> > >
> > >
> > > - Scott
>
> > Im hanging in there but in a very bad way. The NHS want to add lithium. From what I gather from your posts, lithium is not an essential part of your recovery ?
>
> .
>
> No!
>
> Lithium *is* essential for me!
>
> However, lithium produces an antidepressant effect for me *only* at 300 mg/day. Once I increase the dosage to 450 mg/day, I begin to deteriorate. It's amazing. I found some literature that suggests an explanation for this. Lithium demonstrates a bimodal effect on both glutamate neurotransmission and clinical response.
>
> > Do you think it can kick-start the tcp which is no longer working ? Lamotrigine did kick start it many months ago, but then stopped working and has now completely destroyed my memory and Im finding it very hard to come off it. In fact, Im finding it impossible to come off tcp, or lamotrigine or olanzapine. Just dont know what to do.
>
>
> I have responded best to Parnate when it was combined with either desipramine or nortriptyline.
>
> If you have never tried Nardil, I strongly encourage you to do so. It is much better for anxiety than is Parnate. For me, Nardil makes me feel much "brighter" than Parnate. Nardil is also "pro-social". I did not find Parnate capable of doing this, even when it produced a remission of depression.
>
>
> - Scott
>
>
> I thought you said that you take lithium now mainly to stave off Alzheimers.... maybe i misunderstood.Nardil was the first med I was ever put on, and it lasted 22 years before it stopped working. I then went on to parnate which I preferred. It suited me very well and had less side effects than nardil. But it stopped working after I reduced it, and now I am unable to come off it, even though it is no longer totally working. The pain is too great. Same is true for lamotrigine.
Re.lithium, do you do the blood tests regularly... or did you just take 300 mg from the start, without the blood tests?
Lithium doesnt really help with anxiety does it?
Posted by Lamdage22 on April 4, 2022, at 23:56:31
In reply to Re: combining nardil and parnate ) SLS, posted by rose45 on April 4, 2022, at 17:42:26
> Lithium doesnt really help with anxiety does it?
Maybe a little bit. Everyone is different. Are you not interested in reducing suicidality?
Posted by rose45 on April 5, 2022, at 6:13:03
In reply to Re: combining nardil and parnate ) SLS, posted by Lamdage22 on April 4, 2022, at 23:56:31
> > Lithium doesnt really help with anxiety does it?
>
> Maybe a little bit. Everyone is different. Are you not interested in reducing suicidality?
My feeling of suicidality comes from not being able to accept that I have to live from now on as I am now. Its more from an intellectual understanding, if that makes sense.I asked Scott this same question, but do you have regular blood tests for lithium, or did you just decide to stay on a low dose, and do not need blood tests?
>
>
Posted by Lamdage22 on April 5, 2022, at 6:15:57
In reply to Re: combining nardil and parnate ) SLS, posted by rose45 on April 5, 2022, at 6:13:03
> I asked Scott this same question, but do you have regular blood tests for lithium, or did you just decide to stay on a low dose, and do not need blood tests?
I had a blood test once and my doctor said: At that dosage and that blood level, Lithium is extremely unlikely to get toxic.
Posted by SLS on April 5, 2022, at 8:39:01
In reply to Re: combining nardil and parnate ) SLS, posted by rose45 on April 4, 2022, at 17:42:26
> > Hi, Rose.
> >
> > > >
> > > > I don't think I ever asked you how you were feeling.
> > > >
> > > > Don't worry, I won't start now...
> > > >
> > > > Silliness aside, are you hanging in there?
> > > >
> > > >
> > > > - Scott
> >
> > > Im hanging in there but in a very bad way. The NHS want to add lithium. From what I gather from your posts, lithium is not an essential part of your recovery ?
> >
> > .
> >
> > No!
> >
> > Lithium *is* essential for me!
> >
> > However, lithium produces an antidepressant effect for me *only* at 300 mg/day. Once I increase the dosage to 450 mg/day, I begin to deteriorate. It's amazing. I found some literature that suggests an explanation for this. Lithium demonstrates a bimodal effect on both glutamate neurotransmission and clinical response.
> >
> > > Do you think it can kick-start the tcp which is no longer working ? Lamotrigine did kick start it many months ago, but then stopped working and has now completely destroyed my memory and Im finding it very hard to come off it. In fact, Im finding it impossible to come off tcp, or lamotrigine or olanzapine. Just dont know what to do.
> >
> >
> > I have responded best to Parnate when it was combined with either desipramine or nortriptyline.
> >
> > If you have never tried Nardil, I strongly encourage you to do so. It is much better for anxiety than is Parnate. For me, Nardil makes me feel much "brighter" than Parnate. Nardil is also "pro-social". I did not find Parnate capable of doing this, even when it produced a remission of depression.
> >
> >
> > - Scott
> >
> >
> > I thought you said that you take lithium now mainly to stave off Alzheimers.... maybe i misunderstood.
>
> Nardil was the first med I was ever put on, and it lasted 22 years before it stopped working. I then went on to parnate which I preferred. It suited me very well and had less side effects than nardil. But it stopped working after I reduced it, and now I am unable to come off it, even though it is no longer totally working. The pain is too great. Same is true for lamotrigine..
First of all, why do you want to stop taking Parnate? You know that you are most likely a "lifer", right?. The next time you find something that works, don't rock the boat.
How much Parnate were you taking when it worked best? How would you describe the amount of improvement it produced?
As best as I can estimate from my knowledge of the real-life clinical effective dosage range for Parnate is 40-80 mg/day. A special "high dosage" Parnate begins at 120 mg/day.
I have taken 120 mg/day of Parnate in combination with 300 mg/day of desipramine and some Ritalin. Thyroxine (T4) was added at some point. That is, of course, very aggressive.
One strategy for "recapturing" the antidepressant response when you relapse on Nardil is to discontinue it for three months, and then restart it. One of my doctors had a patient who he had to switch back and forth between Nardil and Parnate.
With lamotrigine (Lamictal), not going up to a minimum of 200 mg is usually optimally effective. Lamotrigine is not an all-or-nothing drug. At 200 mg/day, I glean a partial, although significant response. At 300 mg/day, I experience full remission AND the side-effect of memory impairment disappears, and my memory actually improves as the depression is reduced.
In my estimation, the effective dosage range of lamotrigine to treat bipolar depression is 200-300 mg/day.
You never know.
What are your plans at this point?
- Scott>
> Re.lithium, do you do the blood tests regularly... or did you just take 300 mg from the start, without the blood tests?
>
> Lithium doesnt really help with anxiety does it?
Posted by SLS on April 5, 2022, at 8:49:43
In reply to Re: combining nardil and parnate ) SLS, posted by rose45 on April 5, 2022, at 6:13:03
> > > Lithium doesnt really help with anxiety does it?
> >
> > Maybe a little bit. Everyone is different. Are you not interested in reducing suicidality?
>
>
>
>
> My feeling of suicidality comes from not being able to accept that I have to live from now on as I am now. Its more from an intellectual understanding, if that makes sense.
>
> I asked Scott this same question, but do you have regular blood tests for lithium, or did you just decide to stay on a low dose, and do not need blood tests?
Lithium blood levels are irrelevant when using lithium as a low-dosage treatment for depression. The level might not exceed 0.2.mEq/L. You really have to establish the right dosage clinically - trial and error in this case.You simply start at 150 mg/day and go no higher than 600 mg/day. I think that you should stay on each dosage for 2-3 weeks before increasing another 150 mg/day.
I find that taking too much (450 mg/day) lithium exacerbates my depression, and makes me feel flat, apathetic, less creative and generally unmotivated. For me, 300 mg/day of lithium is optimal. Another advantage of using low dosages of lithium is that there is almost no liability for thyroid or kidney dysfunction.
- Scott
Posted by rose45 on April 5, 2022, at 10:58:48
In reply to Re: combining nardil and parnate ) SLS » rose45, posted by SLS on April 5, 2022, at 8:39:01
> > > Hi, Rose.
> > >
> > > > >
> > > > > I don't think I ever asked you how you were feeling.
> > > > >
> > > > > Don't worry, I won't start now...
> > > > >
> > > > > Silliness aside, are you hanging in there?
> > > > >
> > > > >
> > > > > - Scott
> > >
> > > > Im hanging in there but in a very bad way. The NHS want to add lithium. From what I gather from your posts, lithium is not an essential part of your recovery ?
> > >
> > > .
> > >
> > > No!
> > >
> > > Lithium *is* essential for me!
> > >
> > > However, lithium produces an antidepressant effect for me *only* at 300 mg/day. Once I increase the dosage to 450 mg/day, I begin to deteriorate. It's amazing. I found some literature that suggests an explanation for this. Lithium demonstrates a bimodal effect on both glutamate neurotransmission and clinical response.
> > >
> > > > Do you think it can kick-start the tcp which is no longer working ? Lamotrigine did kick start it many months ago, but then stopped working and has now completely destroyed my memory and Im finding it very hard to come off it. In fact, Im finding it impossible to come off tcp, or lamotrigine or olanzapine. Just dont know what to do.
> > >
> > >
> > > I have responded best to Parnate when it was combined with either desipramine or nortriptyline.
> > >
> > > If you have never tried Nardil, I strongly encourage you to do so. It is much better for anxiety than is Parnate. For me, Nardil makes me feel much "brighter" than Parnate. Nardil is also "pro-social". I did not find Parnate capable of doing this, even when it produced a remission of depression.
> > >
> > >
> > > - Scott
> > >
> > >
> > > I thought you said that you take lithium now mainly to stave off Alzheimers.... maybe i misunderstood.
> >
> > Nardil was the first med I was ever put on, and it lasted 22 years before it stopped working. I then went on to parnate which I preferred. It suited me very well and had less side effects than nardil. But it stopped working after I reduced it, and now I am unable to come off it, even though it is no longer totally working. The pain is too great. Same is true for lamotrigine.
>
> .
>
> First of all, why do you want to stop taking Parnate? You know that you are most likely a "lifer", right?. The next time you find something that works, don't rock the boat.
>
> How much Parnate were you taking when it worked best? How would you describe the amount of improvement it produced?
>
> As best as I can estimate from my knowledge of the real-life clinical effective dosage range for Parnate is 40-80 mg/day. A special "high dosage" Parnate begins at 120 mg/day.
>
> I have taken 120 mg/day of Parnate in combination with 300 mg/day of desipramine and some Ritalin. Thyroxine (T4) was added at some point. That is, of course, very aggressive.
>
> One strategy for "recapturing" the antidepressant response when you relapse on Nardil is to discontinue it for three months, and then restart it. One of my doctors had a patient who he had to switch back and forth between Nardil and Parnate.
>
> With lamotrigine (Lamictal), not going up to a minimum of 200 mg is usually optimally effective. Lamotrigine is not an all-or-nothing drug. At 200 mg/day, I glean a partial, although significant response. At 300 mg/day, I experience full remission AND the side-effect of memory impairment disappears, and my memory actually improves as the depression is reduced.
>
> In my estimation, the effective dosage range of lamotrigine to treat bipolar depression is 200-300 mg/day.
>
> You never know.
>
> What are your plans at this point?
>
>
> - Scott
>
> >
> > Re.lithium, do you do the blood tests regularly... or did you just take 300 mg from the start, without the blood tests?
> >
> > Lithium doesnt really help with anxiety does it?
>
>
> Scott,
You may not remember as there have been so many posts on here, but I did mention in an earlier post thatparnate on its own was perfect for me at 30mg. I was on it happily for 6 years,But I went slightly high on it, after a meditation retreat, and so reduced the dose and it stopped working altogether, and the unbearable anxiety which it had been masking came out with a vengeance.
I increased it to 40 mg but it made no difference, and just cannot tolerate it any higher. Same thing happened to me when Nardil stopped working.
In hindsight it was a terrible mistake to lower the dose, but I never imagined it would just stop working altogether.
It is still active at some level and lamotrigine did 'jump start' it but that only lasted for 4 months, and then stopped working altogether. The
lamotrigine has ruined my memory and ability to communicate as I used to- And now im finding it is excessively difficult to come off it also. So now there are 3 meds that I cannot come off : Parnate, Lamotrigine and Olanzapine.
I am in a terrible state, with no memory and anxiety which is so crippling, I dont dare go out on my own further than just my neighbourhood. Ive lost the ability to think things out in my own mind....this is a little worse than the state I was in when I first went on meds - Both nardil and parnate worked for me, but nardil did make me go 'high' and very aggressive.
The NHS (UK free medical) are now suggesting lithium and I have no choice but to agree, otherwise they will discharge me. I cant see how lithium will help the anxiety or give me my memory back....I dont know how I can ever get out of this hell that I am living.
Thank you for all your responses to my posts. You are very kind.
Posted by SLS on April 5, 2022, at 14:22:57
In reply to Re: combining nardil and parnate ) SLS » SLS, posted by rose45 on April 5, 2022, at 10:58:48
Hi, Rose.
Can you describe what are the obstacles that prevent you from discontinuing each drug?
Did what I wrote change anything about the way you plan to move forward?
- Scott
Posted by rose45 on April 5, 2022, at 17:15:45
In reply to Re: combining nardil and parnate ) SLS » rose45, posted by SLS on April 5, 2022, at 14:22:57
> Hi, Rose.
>
> Can you describe what are the obstacles that prevent you from discontinuing each drug?
>
> Did what I wrote change anything about the way you plan to move forward?
>
>
> - ScottScott, I try to reduce the parnate by one 10 mg pill and the pain is excruciating - dont know how to describe it, mental and psychic crippling pain.. I cant tolerate it, and that is just 10mg out of a 40 mg dose. Strange thing is that when I was high on the parnate, I reduced without any problem, but now i just cannot tolerate the pain.
It is similar with lamotrigine - I tried to reduce by 25 mg and the depression and anxiety were unbearable. I have discovered a lamotrigine withdrawal group on facebook, and the people on there suggest reducing very gradually, using a syringe, and lamotrigine dissolved in water. They say its harder to come of f it than benzos - Not everyone experiences it that way, and not everyone has the horrible side effects of memory loss and loss of communication ability, finding the right word etc..I dont know whether managing to come off lamotrigine would bring back my memory or not, or would it make my mental state even worse.
Obviously lamotrigine has worked for you, but it has been terrible for me, except for the 4 months when I was ok.I dont have much choice re. moving forward do I? Adding lithium is the only thing that the NHS can offer. You have told me what works for you
but what options do I have ?I dont think that adding lithium will be a magic cure. But I am depending on a useless mental health dept. What options do I have, if I cannot even get off my meds.
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.