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Re: augmenting an MAOI (Nardil) » atypical

Posted by SLS on July 7, 2010, at 12:58:24

In reply to augmenting an MAOI (Nardil), posted by atypical on July 7, 2010, at 12:41:35

> I currently take Nardil and Lithium as an augmentor for atypical depression/dysthymia (and a little anxiety thrown in too). So far it's been a good combo, but I still have anhedonia, an underlying feeling of sadness, and sometimes more pronounced feelings of being depressed. What might be added to this combo? MAOIs seem to interact with everything.
>
> I have taken Lamictal before (but not with Nardil and Lithium), to no effect. Ritalin doesn't do it for me. Provigil gives me a headache. What about Trileptal? Or are there any TCAs that are highly norepinephrine and really low serotonin affecting so it won't interact with Nardil?
>
> Thanks in advance for any good advice.


I hope I get the same gratitude for my bad advice. :-)

Trileptal is an interesting choice that might have a chance of working. Its antidepressant effects are thought to involve dopamine.

Nortriptyline is probably the best choice of a TCA to add to a MAOI. In my experience, it is "smoother" than desipramine and is less cardiotoxic. That being said, I have had some luck with combining desipramine and Parnate. Doxepin and trimipramine are also worth considering if you have already demonstrated some responsivity to them. I would stay away from imipramine and clomipramine.


- Scott


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