Posted by jerrympls on January 21, 2004, at 18:59:47
In reply to Re: maoi dexedrine Jerry, posted by Maxime on January 21, 2004, at 11:49:52
> I just want to thank you for that Jerry. I have been sitting at 80 mg of Parnate now for almost a year. While my depression has improved I am often depressed and suicidal. I have tried so many meds at this point that my only other option is ECT which I don't really consider an option.
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> I am printing this out and bringing it to my PDOC.
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> Maxime
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> > Excellent, thanks jerry, I missed this on my last exploration of the tips page.
> > I've been on MAOIs and Adderall in combo twice, adding the Adderall after a month on the MAOI. The mental effect was great, my body just couldn't take it. But I'm very odd, I never had the feared hypertension, my bp dropped so low even while lying down that I ended up in the hospital. Nonetheless, I'm seriously considering trying it again now with Ritalin. As usual, it's a tough risk/benefit decision...
> > K.
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>Karen-
Here are some abtracts I got directly from Dr. Ivan Goldberg (he runs Depression Central) - print them out as well!
My favorite line from the second abstract says: "Patients with "treatment resistant" depression who do not respond to standard methods or relapse over time have a moral and legitimate right to innovative therapy."
We should make bumper stickers!
Good luck!
Jerry
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1: J Clin Psychopharmacol. 1991 Apr;11(2):127-32.
CNS stimulant potentiation of monoamine oxidase inhibitors in
treatment-refractory depression.Fawcett J, Kravitz HM, Zajecka JM, Schaff MR.
Department of Psychiatry, Rush-Presbyterian-St. Luke's Medical Center,
Chicago,
Illinois.We report on our clinical experience with a combination of a CNS stimulant (either pemoline or dextroamphetamine) and a monoamine oxidase inhibitor (MAOI) for treating 32 depressed patients (mainly outpatients) refractory to standard
antidepressant pharmacotherapy. This combination, though not approved by the FDA, appears to be safe and effective. Twenty-five (78%) of these patients experienced at least 6 months of symptom remission with a stimulant + MAOI combination. Many patients required adjunctive antidepressant treatment, including tricyclics and lithium. Side effects were not excessive, though 6 patients (3 unipolar and 3 bipolar) cycled to mania (N = 1) or hypomania (N = 5). None developed hypertensive crises. With properly motivated and complaint patients and careful clinical monitoring by the prescribing psychiatrist, stimulant potentiation of MAOIs may be a viable option for treatment-resistant depressed patients.PMID: 2056139 [PubMed - indexed for MEDLINE]
2: J Clin Psychiatry. 1985 Jun;46(6):206-9.
Combined MAOI, TCA, and direct stimulant therapy of treatment-resistant depression.
Feighner JP, Herbstein J, Damlouji N.
Patients with "treatment resistant" depression who do not respond to standard methods or relapse over time have a moral and legitimate right to innovative
therapy. Combined treatment with monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), and stimulants has been resisted by practitioners because of hypertensive and hyperthermic crises noted in certain cases. This paper reports a case series demonstrating the safety and efficacy of adding a stimulant to an MAOI or to a combination of TCA and MAOI in the treatment of intractable depression.PMID: 3997787 [PubMed - indexed for MEDLINE]
poster:jerrympls
thread:303285
URL: http://www.dr-bob.org/babble/20040118/msgs/303896.html