Posted by SLS on January 5, 2007, at 6:27:12
In reply to Re: General Maoi Tip-SLS, posted by tessellated on January 4, 2007, at 15:36:22
> yep, i hate that bitter pill. i only get the parnate "golden mean" after having taken it for fourteen hours. then it turns me into some vampire like superhuman, working all night 36hrs etc...then crashing for 12-14.
Have you tried to use benzodiazepines for sleep and keep your sleep-wake cycle as normal as possible? When I was on Parnate + desipramine, it was the only way I could sleep at all. I used a combination of Halcion + Ativan. I don't recommend Halcion, though. It can cause rebound anxiety and even provoke mania in susceptible individuals. You can try the Ativan first. If it is unable to put you to sleep, you can either add a more potent short acting drug like Sonata, or consider using 25-50mg of Seroquel.
> i'm a tad fearful of the manic potential insomnia itself has.
Yup.
> so i've switched over to milnacipran, because of it chemical similarity to parnate.
Hmm! I didn't know that. I have been interested in that drug, but not for that reason. Now you've got me more interested.
> its more often compared to cymbalta due to its SNARI profile. damn stuff isn't in the states, but is worth looking into.
I believe it is being looked at in the US for treating fibromyalgia. I think it has a good chance of getting approved.
> Scott,
> Not to be blunt, but wow you got a heck of a line up going on there.Why, thank you. ;-)
> Layer after layer of anticonvulsants/antipsycho's, i would imagine would give anyone a zombie ride. i think i lost it trying to combine seroquel with parnate, passing out convulsing, etc.
Well, forget about my Seroquel suggestion.
> i'm tending to err on the side of minimizing polypharmacy options, because there are no controls, and so many variables, including different rates of receptor adaptation.
> i just took a break of about two months from any constant meds to see what my baseline was, and all the paranoia/mania just dissapeared.Do you have any guesses as to which drugs might have been causing you problems?
There is sometimes a rebound improvement immediately after the discontinuation of drugs, although I wouldn't know if that were to apply to you. I hope you remain improved.
> obviously you've spent time developing this cocktail, so this is nothing more than a common sense suggestion: reduce variables.
Thanks. I might try to discontinue the Abilify soon.
> it sounds ridiculous, but realizing my baseline didn't involve paranoia/anxiety/mania, was a HUGE relief.
Let's hope it's not only a rebound improvement. One tends to think of depression when it comes to this effect. I haven't heard of it with mania and paranoia.
> you got a lot of neural inhibition happening in both the membrane pumps and through gaba, not to mention whatever the heck the monoamines are doing. i think anyone would feel pretty leaden on your line up.
Actually, each of the drugs I'm on add to an increase in mental energy and clarity. I am less depressed in general. As you said, I have settled on these drugs after years of experimentation. I have tried to discontinue each drug one at a time to evaluate its importance to the treatment regime. Abilify is the one that I have yet to experiment with. I have remained on it because I know it has an anti-suicide effect much like Zyprexa. However, I don't reach that state often, and perhaps I could use it only during such difficult times. I did experience a noticeable increase in mental energy and motivation when I first started taking Abilify, but who knows if that effect has persisted.
> what the heck does a neuron do when you're hitting it with simultaneous agonists/antagonists?
At this point, I try to strike a balance between deduction and empiricism with greater weight given to empiricism. I think we sometimes stumble over ourselves, thinking that we can somehow deduce how drugs and drug combinations will affect us given the relatively crude understanding of the brain and pharmacology that science has so far produced. That leaves trial and error. I just try to make sure that I don't pretend to be smarter than the scientists. As it happens, I don't think there are any antagonistic pharmacodynamics between the drugs I am taking. I could be wrong. Out of curiosity, do you see any?
Thanks again.
- Scott
poster:SLS
thread:718137
URL: http://www.dr-bob.org/babble/20070101/msgs/719498.html