Posted by tom2228 on May 23, 2014, at 11:14:52
In reply to Re: Desoxyn with MAOIs --) SLS » tom2228, posted by SLS on May 23, 2014, at 10:28:05
Scott, I really encourage you to try Desoxyn with Parnate, especially since you are coming off the nortriptyline -- that should lessen the serotonergic load. It is safe, coming from the man Stahl himself (I was and still am in sheer aw when my doc told me he had corresponded with him about my case!). I have been on MAOIs (including Parnate up to 60mg, Marplan up to 50mg, and Nardil up to 75mg) with up to 25mg Desoxyn for the past 4 years with no problems.
The potency of NE:5-HT is about 1:44 in terms of neurotransmitter release. Bear in mind that (meth)amphetamine-mediated neurotransmitter efflux inherently is accompanied by reputake inhibition as the efflux occurs through the transporter itself in the reverse direction, independently of cellular stimulation. But recall that nortriptyline and desipramine are also SRIs; while this is comparatively less with respect to their noradrenergic activities, it is still clinically relevant, but somehow safe. Sometimes we must simply trust our doctors as experience may speak louder than pharmacodynamics. Desoxyn can help with depression and anxiety more so than the other stimulants, in my opinion and experience.
Yes, I experienced the uncomfortably energetic/ stuttering while speaking experience that I refer to as "tweaky" when adjusting to the first few days of nortriptyline at 75mg. I took the first desipramine dose last night and don't feel too many sides since we're starting low. These two are much nicer to me than Wellbutrin, which I just tried with my previous doc the past week in place of nortriptyline.
Yeah, I understand things like dry mouth can be just as bad as on nortriptyline, but the main benefit is that the pseudoanticholinergia lacks the cognitive impairment of the true version produced by nortrip, which was causing me problems in school along with the sedation. Am looking froward to the thermogenic properties of desipramine as I gained 15lbs on Abilify + nortrip in 2 months.
I think you are brave for coming off much of your medication and am rooting for you. I am likely starting rTMS (Neurostar machine) in a few weeks if we can convince insurance to cover it for *bipolar* depression.
In the mean time I will likely be coming off of Abilify for the same reasons you state along wtih apathy, disinterest in things/ people, and trialing Invega. My doctor seems just as interested in trying out Namenda XR as I am to replace Mirapex and augment cognition and mood. Have you tried memantine?
That is interesting about prazosin replacing nortriptyline because nortriptyline has effects on the same site, a1 antagonism. My thinking is that this aspect of the drug's profile tempers the NRI effect to make it less harsh, less anxiogenic/ tweaky/ physically uncomfortable. I hope the Prazosin works out well for you.
I can't say much about the Brintellix but I imagine it would be no better than an SSRI augmented with an AAP to get the serotonin antagonism that Brintellix has. I would suspect that an MAOI + AAP would get the job done even better, but everyone is different.
poster:tom2228
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