Posted by ed_uk2010 on February 14, 2015, at 10:25:13
In reply to Re: Sleep, FOOD, fluids and hypotension. » ed_uk2010, posted by Robert_Burton_1621 on February 14, 2015, at 7:33:20
Hi,
>I am only drinking white wine since the move to parnate. But I don't want to, and I know that it is just another confounding factor.
Perhaps it will help you to resist if you bear in mind that white wine does sometimes contain tyramine, so it's best to avoid drinking a lot. The tyramine content may vary between batches. A small amount of white white is likely to be safe, but may not provide the 'self medication' effect which makes you drink it in the first place. Large amounts are obviously best avoided. So maybe just avoid it? Easier said than done, but I think you can do it.
>Be that as it may, what I think I will do is prepare some meals in advance and freeze them, so I can eat even if I am feeling weak.
Some bulk preparation sounds like a good idea.
>Was this made for the purpose of negating quickly my minimum-calorie consumption over the last three days
Yes, exactly. You hadn't had enough calories to feel well.
>there's something about Parnate which makes a (within reason) high-calorie diet beneficial or important?
No, not at all.
>I've had some itching from the temazepam, I assume - scalp, eyes, ears, lips, tongue. It's not unbearable, but it is annoying.
I'd request something else. Temazepam is anxiolytic, but obviously wasn't sedating enough for you, and the itching is not a good sign. I would consider zopidem, zopiclone... or perhaps cyproheptadine, if available.
>Thanks for the list of alternatives. Would you consider doxepin potentially useful?
Possibly. Doxepin is a very potent antihistamine, a serotonin 5-HT2 receptor antagonist and a weak serotonin reuptake inhibitor. Because there isn't much experience combining it with MAOIs, I would suggest something lacking the SRI effect first. Doxepin is also very long-acting to use as a sleep aid.
>Mirtazapine (small dose) knocked me out in 15 minutes when i was taking it at night with Effexor. Is taking that out of the question?
No, it's not out of the question at all, but I don't know whether your doc would agree to it. He might feel worried simply by the fact it's another antidepressant. Although drugs with moderate or strong SRI effects are the major concern by far, doctors who do not use MAOIs regularly may not be too comfortable prescribing any other antidepressants at the same time. I think it depends a lot on the psychiatrist. I do suspect cyproheptadine would help. It shares a strong sedative antihistamine effect and 5-HT receptor blocking property with mirtazapine.
>Sorry - I'm imposing on you with all of these questions!
No problem!
>i know pizotifen is prescribed as a prophylactic, but when I took it it actually "cured" the transformed-migrainous state I was in for many weeks - overnight.
In that case, I wouldn't be surprised if the closely related serotonin antagonist cyproheptadine might do the same. Cyproheptadine is shorter-acting than pizotifen and possibly more sedating; I would suggest it might be more suitable as a sleep aid. If used for migraine, cypro is taken during the day as well as at night, but the first few doses should be given at night.
I feel like I'm selling cypro! This is uncommon - it just seems to fit your symptoms and med history particularly well!
>I have just learnt from your comment that it's possible for something to be a serotonin antagonist and yet have serotonin reuptake inhibition as well.
A lot of antidepressants have both properties, amitriptyline is a good example.
>I do have a lot to learn.
I don't know about that, but... I wrote you a post at the top of the page in the Effexor + Remeron vs Parnate thread. I called it 'pharmacology'. It might be of some use.
Take care.
poster:ed_uk2010
thread:1075968
URL: http://www.dr-bob.org/babble/20150129/msgs/1076607.html