Posted by desolationrower on May 1, 2011, at 17:10:38
In reply to Re: Suggestions for further medications, posted by Deepreason on April 30, 2011, at 19:43:17
> > also, valproate and phenelzine share a mechanism in common, so it could either do the same thing, or be additive. Perhaps you are responding differently than most people starting phenelzine because of this (less initial benefit)
> >
> > -d/r
>
> I'm interested in more info on this subject as in addition to the anxiety I was also experiencing a spaced out feeling that was very similar to how I felt when I increased my valproate dosage too high in the past. A kind of hypnotised, muzzy feeling like I was moving in treacle.
>
> I had inititally attributed this to the couple of extra diazepam I'd taken to offset some of the anxiety but again in hindsight, your suggestion of a possible synergy between the valproate and the phenelzine would feel closer to my exeperiences.
>
> Could you point me in the direction of your source please? I have full journal access to look things up.they are both gaba-transaminase inhibitors. i think phenelzine is indirectly, a byproduct of mao metabolism or something.
I don't really stay organized in my sources, i just remember stuff i read. i use scholar.google.com. here is an paper that deals with it though: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1408023/
Anyway, maybe someone else know, but i forget how quickly antipsychotics work for OCD (as an addon to serotonergic drugs). quietiapine has the most 'other' stuff so you probably were getting 100% side effects (some people like those, especially the tiredness) so i'm surprised you ahven't been given another ones, like risperadone. It is pretty established as an add-on to a drug like an sri. Perhaps because of the mirtazapine, which has some similarities. but i think the d2 antagonism might be helpful to some degree... Normally, even for social anxiety, i think AA are bad, but you might find otherwise, because it sounds like OCD is really at the core here. It might help with the 'agitation' from starting an MAOI, if it is from excess 5ht2 activity.
Serotonin syndrome is from excess 5ht2 activation, so the fact you had this makes me think you might have some really overactive 5ht2
receptors that need to be dealt with... MAOIs and sometimes sris reduce 5ht2 receptor activity, but so do 5ht2 antagonists (which is weird and backward)
-d/rBetter living through chemistry, socialism, and big phallic rockets (with a side of roquette)
poster:desolationrower
thread:984054
URL: http://www.dr-bob.org/babble/20110418/msgs/984297.html