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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by uncouth on November 26, 2008, at 13:15:52
I know MAOI plus 5-htp is a big no-no, but some pubmed studies from ages ago showed that MAOI plus L-Tryptophan (up to 10g a day!) can rapidly improve symptoms.
Is anyone on this board augmenting their MAOI with L-Tryptophan, and if so, with how much, and with what success? Any hypomanic/serotonin syndrome symptoms creep up?
I'm on 80mg of Parnate and seeing partial response. Also on abilify and tianeptine and trying memantine. SNRIs have worked for me in the past but send me a bit hypomanic, and don't do enough for dopamine so I end up a compulsive, hypomanic mess with really bad ADHD. So I need something for dopamine hence the parnate. But I'm not sure it's as strong as 300mg of Effexor was in terms of serotonin, so i'm looking to boost with L-Tryptophan.
Posted by Sigismund on November 26, 2008, at 13:27:33
In reply to MAOI plus L-Tryptophan, posted by uncouth on November 26, 2008, at 13:15:52
Around 1974 I read an abstract of a trial of L-tryptophan with various MAOIs.
I forget which ones, but certainly Nardil, Marplan or Parnate would have been the only options.There was some success, as I recall.
Posted by Cady on December 7, 2008, at 17:08:54
In reply to MAOI plus L-Tryptophan, posted by uncouth on November 26, 2008, at 13:15:52
I tried 5-htp while also taking Lamictal (mood stabilizer that does not act directly on serotonin). It made me feel caffeinated, so I stopped.
I would be cautious about l-tryptophan as well, since like 5-htp it is a serotonin precursor. There may have been less known about serotonin syndrome when the older studies were done.
May I ask a question about your experience with the SNRIs? Do you think they gave you new symptoms, failed to control existing symptoms, or made existing symptoms worse, in terms of hypomania, compulsive behavior, ADHD? Would you say the compulsiveness and ADHD are part of the hypomania or not? Any info you could share would be appreciated. I have a similar mess of symptoms, and I'm trying to get my meds right. Thanks.
Posted by uncouth on December 7, 2008, at 17:19:39
In reply to Re: MAOI plus L-Tryptophan, posted by Cady on December 7, 2008, at 17:08:54
No, do not think they were part of the hypomania, though they might have been. I think it was serotonin overdrive at the expense of dopamine. Even when i didn't feel as sped-up on my SNRI regime, I had bad ADHD. Though it was responsive to Focalin.
I think i will eventually go back and try Pristiq this time, as the Parnate isn't doing the trick unfortunately, and is causing lots of anxiety.
I do think the Pristiq + Abilify combo is a really killer one. Brings you up, but abilify controls the speedy thoughts and can improve dopamine signaling, and help with mood stabilization.
Lamictal at 200mg eventually, over time, made me a bit cognitive dull -- especially when speaking (word finding difficulties seem to be a relatively common occurance with high dose lamictal).
This is the end of the thread.
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