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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by PeterMartin on June 15, 2019, at 22:34:25
I currently take Marplan (MAOi). I've had issues w/ sleepiness and lack of motivation for a few years now (including through a trial on Nardil last year). My doctor suggested/oked adding a 5mg dose of Ritalin to my medicine regime.
I've taken Ritalin before up to 60mg. It was effective but generally short lived (tolerance) and with a peak at ~an hr and then an anxious come down.
It's only been 3days taking the 5mgX2 w/ my current cocktail (Marplan 40, Lamictal 250, Metformin 1000, Seroquel 25 for sleep). The first day I felt pretty good. The 2nd and 3rd kinda blah to be honest. I still get a little peak / burst of feeling good/interest an hour or two after taking it but shortly thereafter I find myself not wanting to do anything at all.
There were a few times where I felt like maybe it was helping but it'll just take some time for me to stop expecting a caffeine type burst (that I definitely used to get on higher dosages of Ritalin).
My question though is since I'm taking Marplan will the effects of Ritalin build up? Like I have higher dopamine levels after a week or two of taking this small dose of Ritalin? Or will it still more or less act in the short term?
I have a blood pressure cuff and surprisingly my blood pressure has been on the low end as it usually is on Marplan. Today at 7pm after an AM/5PM dose of Ritalin it was 97/60 pulse 95. So as far as using them together everything seems ok there.
I guess I'm just hoping using Ritalin consistently will maybe kickstart Marplan a bit. My moods haven't been great the past few weeks. I have good days and days where I just sleep, get up to pee/take my dogs to pee, and then sleep.
If anyone has any words of encouragement I'd appreciate them :)
Posted by Christ_empowered on June 16, 2019, at 12:01:52
In reply to Ritalin + MAOi - Will benefits appear over time?, posted by PeterMartin on June 15, 2019, at 22:34:25
ritalin is more like cocaine than it is amphetamines. this is probably why the cool kids call it 'kiddie cocaine,' lol.if i recall correctly, it inhibits the reuptake of dopamine and norepinephrine. this is a bit different from dexedrine, adderall, etc...the amphetamines both release dopamine and inhibit the reuptake, which is probably why amphetamines are regarded as more potentially euphoric and addictive than ritalin, focalin.
as for benefits...there's only limited, mostly old(er) information on uppers w/ maoi drugs, and most of that involved the amphetamines. having said that, there have been much more recent studies using ritalin and more popular antidepressants in select groups (the elderly, for instance), and the results in those very small studies seem to indicate that ritalin accelerates response to antidepressants and (predictably) helps with fatigue, lethargy, concentration, etc.
obviously, serotonin syndrome is a concern when stimulants are added to any sort of antidepressant.
sorry i couldnt be of more help.
Posted by PeterMartin on June 16, 2019, at 15:18:12
In reply to Re: Ritalin + MAOi - Will benefits appear over time?, posted by Christ_empowered on June 16, 2019, at 12:01:52
Thx Christ_empowered. The mention that ritalin can accelerate response to ADs is a helpful reminder.
This morning was better than the last few. Got in to a project which helped. I'm just hoping once the immediate (mild) burst after each dose subsides due to tolerance I'll find it's still helping. In the past I've kinda chased that rush.
I'm taking a very small dose but I'd prefer to keep it that way. Hoping the MAOI keeps the NE/DA up....
Posted by sigismund on June 17, 2019, at 2:31:25
In reply to Re: Ritalin + MAOi - Will benefits appear over time?, posted by PeterMartin on June 16, 2019, at 15:18:12
Take a smaller dose more often?
Otherwise it's not very smooth.
Posted by Christ_empowered on June 17, 2019, at 13:07:49
In reply to Re: Ritalin + MAOi - Will benefits appear over time?, posted by sigismund on June 17, 2019, at 2:31:25
there are a number of long acting ritalin preparations out there. ritalin la was OK for me. I think focalin xr would probably pack more of a punch and maybe be a bit smoother (?), but that's a guess, at best.
the benefits in add/adhd can be ascertained after a couple of weeks...maybe add on treatment in depression is similar? wish i could be of more help.
Posted by pedr on June 18, 2019, at 15:56:05
In reply to Ritalin + MAOi - Will benefits appear over time?, posted by PeterMartin on June 15, 2019, at 22:34:25
> It's only been 3days taking the 5mgX2 w/ my current cocktail (Marplan 40, Lamictal 250, Metformin 1000, Seroquel 25 for sleep). The first day I felt pretty good. The 2nd and 3rd kinda blah to be honest. I still get a little peak / burst of feeling good/interest an hour or two after taking it but shortly thereafter I find myself not wanting to do anything at all.
This is what I experience with Ritalin / Adderall. It's literally the only substance on the planet that allows me to feel human. BTW you're lucky finding a PDoc "adventurous enough" to prescribe stims + MAOI. Most will laugh in your face if you request it. However I was the best I've ever been in 24 years on stims + MAOI. I could get through most of the day on it, it was amazing. Now I just have Oxycodone (for pain) + Adderall (for likely ADD) to rely on for feeling human for 2-3 hours a day -_-
> My question though is since I'm taking Marplan will the effects of Ritalin build up? Like I have higher dopamine levels after a week or two of taking this small dose of Ritalin? Or will it still more or less act in the short term?
I didn't find that the effects built up personally although YMMV of course. Personally I found that the effects waned over time if anything. That's certainly the case for me when taking stims without MAOI's. I was "good" for 3-4 months on Vyvanse (Adderall XR basically) - I wanted to do things and was interested in life for most of the day. Then it just helped for shorter and shorter periods. Now I'm just clinging on desperately to the 2-3h I get -_- It's a pretty dismal situation.
I hope you find some persistent respite.
Pete
Posted by PeterMartin on June 19, 2019, at 19:57:04
In reply to Re: Ritalin + MAOi - Will benefits appear over time? » PeterMartin, posted by pedr on June 18, 2019, at 15:56:05
Thanks everyone!
And yea my pDoc was fine w/ the combo.....the pharmacist, on the other hand, asked if I was still taking an MAOI. I get it elsewhere now and didn't feel like discussing it so just told her no.
Posted by Stargazer2 on June 25, 2019, at 23:54:57
In reply to Re: Ritalin + MAOi - Will benefits appear over time?, posted by Christ_empowered on June 17, 2019, at 13:07:49
Ritalin 5 mg is probably not enough. Im on Nardil and Ritalin and have to be careful. 10 mg has been better but the risk of a hypertensive crisis looms over me as I had the reaction before taking Ritalin 10. Its not worth the risk again. I rethink 7.5 is ok because I took that before. Ill drink too much coffee sometimes trying to up my energy level and motivation. I either up the side of Nardil but then my weight increases 20 pounds.
I constantly change my dosages chasing a normal feeling.
Posted by pedr on June 26, 2019, at 7:17:13
In reply to Re: Ritalin + MAOi - Will benefits appear over time?, posted by Stargazer2 on June 25, 2019, at 23:54:57
> I constantly change my dosages chasing a normal feeling.
Yup. I did however find that stims + Nardil was golden for me - felt the best I've felt in 25 years. For some reason I ceased taking the combo. IIRC my doctor was no longer comfortable with it -_-
This is the end of the thread.
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