Posted by KaraS on December 21, 2004, at 23:45:18
In reply to Re: Maprotiline + MAOI? » KaraS, posted by SLS on December 20, 2004, at 7:16:18
> Hi Kara.
>
> > Can maprotiline be taken with an MAOI?
>
> I don't know for sure, but I would guess that you can. I'm sure you are aware that it is a relatively selective inhibitor of NE reuptake relative to 5-HT. However, I would be more inclined to go with nortriptyline or trimipramine or even desipramine if you are intent on using a TCA for anxiety and are looking for compatability with an MAOI.I would prefer nort. or desipramine bu they cause tachycardia for me so that wouldn't be great for the anxiety now. Trimipramine would probably be a good bet. I have mixed feelings about going to an atypical AP if I have other options though.
> What other treatments have you considered for anxiety? Do you have these medications on hand? Zyprexa would be effective I bet, and would probably add some AD effects. It is also compatable with MAOI.
>Doxepin and maprotiline and the SSRIs have all worked really well for me for anxiety. Right now all I'm taking is niacinamide. It acts like a strong benzo for me only it's not as clean feeling (strong antihistaminic effects) but since I develop tolerance almost immediately to benzos, this has been an unbelievable help. It's allowed me to function somewhat until I can talk to my doctor and get on something else. Today I felt almost normal once I had taken my morning dose.
> My guess is that the contraindications for hyperthyroid patients of TCAs and maprotiline involves NE reuptake inhibition, anticholinergic effects, and the consequences these actions have on an already accelerated heart-rate, palpitations, and arrythmias. Remember, however, that thyroid hormone is often given in supratherapeutic dosages to augment TCAs. I wouldn't worry too much about it.
>That was my guess too and I understood why they would say don't take if you are hyperthyroid. I just didn't understand why they'd say don't take if you're taking thyroid meds period. Maybe it's another one of those times where they're covering their butts.
> If you are going to choose Parnate, it would be a good idea to monitor for a hypertensive reaction upon initiating treatment. This sometimes occurs as a startup effect, and is not dosage dependant. Symptoms of a reaction would include:
>
> • occipital headache which may radiate frontally
> • palpitation
> • neck stiffness or soreness
> • nausea or vomiting
> • sweating (sometimes with fever and sometimes with cold, clammy skin)
> • photophobia
> • either tachycardia or bradycardia
> • constricting chest pain
> • dilated pupils
>
>
> - Scott
How common is it to have one of these start up effects from Parnate? That list is enough to scare anyone to death. What we go through just to feel normal! I have my doubts whether I'll be able to tolerate Parnate or Nardil. When I take dopaminergics, they put me to sleep at first and then in time they make me feel sick. My head starts to feel like it's going to explode. Or, maybe I'll just have to go really slowly and I'll have the same kind of experience that Todd had only probably more intense.Anway, thanks for all of the information and advice.
Kara
poster:KaraS
thread:431820
URL: http://www.dr-bob.org/babble/20041217/msgs/432697.html