Posted by SLS on June 28, 2005, at 8:36:19
In reply to Re: Riluzole_and_Lamactil » SLS, posted by EERRIICC on June 28, 2005, at 0:20:23
Hi Eric.
Wow! That is quite an adventurous plan you have there.
> 1.Add Strattera 18mg which (from past experience) should completely normalise my sleep patterns, which Parnate disturbs.I see no problem with this. I'm just surprised that it works. Something for me to remember. I wish Parnate still caused insomnia for me. It always signalled the onset of an antidepressant effect.
> 2.Add Adamantine/Memantine to create synergy.
You took the words right out of my mouth. Because I received more of an antidepressant effect from memantine than from amantadine, I am partial to the memantine. I hope it acts to prevent tolerance to the antidepressant effects of Parnate.
> 3.Add Protriptyline, its stimulant actions seem right up my Parnate responding alley, so why not?
I am leery of protriptyline. I just don't like the drug. It seems to be overly sympathomimetic. I would instead recommend desipramine. Again, though, I am basing this bias on my personal experience with these drugs. I don't really know if you could find much in the literature differentiating the safety of the two drugs when combined with Parnate.
> 4.Take one or two days off of Parnate every week. (Why exactly I have no idea except some vague ideas along the lines of re-invigorating stimulants and coffee)My first reaction is to recommend not "pulsing" the Parnate this way. Although the half-life of Parnate is as short as 2 hours, its MAO-inhibition persists for days. I think the net effect would be to simply leave you undermedicated. HOWEVER, I can't really know for sure that you wouldn't be hitting the bullseye with your idea. If you feel strongly enough about it, I don't think it would hurt to try. If you don't get the results you are looking for, you have the option of returning to your therapeutic dosage or discontinuing it.
I have heard of at least one case where the patient rotated between Parnate and Nardil. The switch was made whenever the current drug lost its effectiveness. It worked, and less time was spent without having an antidepressant on-board.
You might be surprised how well simply adding desipramine might work. I think I would start there.
Regarding riluzole, the only thing I can say is that it did not show any signs of exerting an antidepressant effect for me. However, my degree of treatment resistance makes me a pretty poor global forecaster of the utility of any one drug. If you can afford the riluzole, you might as well give it a try and hope that the enthusiasm of the NIMH is justified.
I would be interested to know what decisions you come to. They aren't easy ones to make, but I think you will hit on one of them.
Good luck.
- Scott
poster:SLS
thread:519627
URL: http://www.dr-bob.org/babble/20050627/msgs/520429.html