Posted by ChicagoKat on October 5, 2012, at 15:29:00
In reply to Re: A call to my White Knights Jono and SLS for advice » ChicagoKat, posted by SLS on October 5, 2012, at 13:33:01
> > Scott...I just want to make sure, if I took 150mg/day of elavil with 45mg/day of nardil, that it would be safe?
>
> Been there, done that...
>
> It was safe enough for me. Hopefully, it will be for you, too.
>
> The only thing I can think of that would be unsafe about this combination is the possibility that it would precipitate serotonin syndrome. You should get familiar with its signs and symptoms, just in case. I really don't see it happening, though.
>
> Because of its anti-cholinergic, central pro-adrenergic, and peripheral NE alpha-1 antagonism, adding amitriptyline to Nardil might produce some problematic hypotension, tachycardia, and urinary retention that will need to be remediated pharmacologically. These things are less of a problem when the dosage of Nardil is kept below 60 mg/day. Let's see what happens and take it one step at a time.
>
> Good luck!
>
>
> - ScottThanks for your thoughts Scott. I've had serotonin syndrome (prozac + robitussin DM, dumb me), so I know the signs and symptoms. and i have some thorazine in case i should ever get it again.
my biggest worry autonomic-wise is reflex tachycardia. how the heck can i treat that when the only options i can think of are beta blockers or non-dihydropyridine calcium channel blockers, both of which will obviously just make the hypotension worse. do you know of anything else i could take?
Lastly, I really wonder how much a TCA, no matter which one i go with is gonna help me. They've never helped in the past, so why should they now? my pdoc did mention a sort of catalyst effect they have when used with MAOIs, but i didn't ask him about the mechanism of that. do you have any other arguments in their favor when combined with MAOIs, despite the fact they've never helped on their own?
Thanks as always, you are the best.
Kat
poster:ChicagoKat
thread:1027658
URL: http://www.dr-bob.org/babble/20121001/msgs/1027763.html