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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by ace on December 8, 2003, at 23:39:19
I'm thinking of adding on 2.5mg Zyprexa to my current combo of 90mg Nardil (the BEAST!!) and 50mg Amisulpride.
I would do this for a short period- a month or two at very most. Who deems such a move by Mr. Ace as safe?????????
Thankyou my lovely friends..........
Ace.
Posted by ace on December 8, 2003, at 23:40:49
In reply to Nardil + 50mg Amisulpride + 2.5mg Zyprexa safe???, posted by ace on December 8, 2003, at 23:39:19
Oh yes, I know prolactin might be a prob (probably not in short term but), but apart from that..?
Posted by SLS on December 9, 2003, at 7:36:25
In reply to Nardil + 50mg Amisulpride + 2.5mg Zyprexa safe???, posted by ace on December 8, 2003, at 23:39:19
> I'm thinking of adding on 2.5mg Zyprexa to my current combo of 90mg Nardil (the BEAST!!) and 50mg Amisulpride.
>
> I would do this for a short period- a month or two at very most. Who deems such a move by Mr. Ace as safe?????????
>
> Thankyou my lovely friends..........
>
> Ace.
I cannot think of anything that would contraindicate such a combination. However, I am not a pharmacologist MD. It is possible that no one has tried this combination to be able to report on its safety. Because the degree of uncertainty is so high, I suggest proceeding cautiously - low and slow.I noted your comment in another thread regarding the possibility that higher dosages of Zyprexa are counterproductive. I don't know for sure, but that just doesn't sound right to me. 5mg seems like a good dosage to be sure to glean the optimal antidepressant effect from Zyprexa. I found that Abilify produced a better, albeit brief, antidepressant response. I have no idea as to how well it would work for OCD.
- Scott
Posted by ace on December 9, 2003, at 18:54:47
In reply to Re: Nardil + 50mg Amisulpride + 2.5mg Zyprexa safe???, posted by SLS on December 9, 2003, at 7:36:25
> > I'm thinking of adding on 2.5mg Zyprexa to my current combo of 90mg Nardil (the BEAST!!) and 50mg Amisulpride.
> >
> > I would do this for a short period- a month or two at very most. Who deems such a move by Mr. Ace as safe?????????
> >
> > Thankyou my lovely friends..........
> >
> > Ace.
>
>
> I cannot think of anything that would contraindicate such a combination.Me either- a serotonin syndrome is not a possibility nor is a hypertensive reaction.
However, I am not a pharmacologist MD. It is possible that no one has tried this combination to be able to report on its safety.Yeah, I mean, I can hardly get literature on any MAOI combos, let alone one with this degree of...sahll I say 'innovation'!
Because the degree of uncertainty is so high, I suggest proceeding cautiously - low and slow.Oh yeah, Just the 50mg Amsidulpride and no higher than 2.5 nocte with the Olanzapine. I will be extra vigilant to s/effects and any new untoward reaction. Frankly though, apart from added appetite stimulation and extra sedation, I see the prospect of any new s/effects quite low.
> I noted your comment in another thread regarding the possibility that higher dosages of Zyprexa are counterproductive. I don't know for sure, but that just doesn't sound right to me. 5mg seems like a good dosage to be sure to glean the optimal antidepressant effect from Zyprexa. I found that Abilify produced a better, albeit brief, antidepressant response. I have no idea as to how well it would work for OCD.
Scott- this is always something that intrigued me. When I first started Zyprexa 2.5mg quickly set Nardil off in a great way- It really kicked in. However, after nearly 3 weeks of raisng my Olanzapine (up to 7.5mg at one point) I suffered an intractable depression. Ceasing Zyprexa did not help. Highering Nardil did not. I had to LOWER Nardil along with ceasing Zyprexa to recover and regain some AD effect from Nardil.A month later I gave Zyprexa another shot to regain the Nardil AD qualities. This time It didn't work, and further, after being at 2.5mg for three weeks, i raised to 5mg for just ONE day...the next day I suffered depression, and had to stop Zyprexa and lower Nardil.
This is weird. I really want your opinion on this. At 5mg Zyprexa would be acting as more as a 5HT and DA AGONIST right? Someone suggested that the depression stemmed from upregulation of the receptor in response to 5HTa receptor blockade.
I'm not sure- did too much 5HT cause the depression? Was Zyprexa acting as an ANTAGONIST for DA and 5HT, thereby negating Nardil's actions?
Help me out!
BTW, good to see you posting regularly again dude! You've had a hard time lately?
Ace..................
>
> - Scott
>
>
Posted by SLS on December 11, 2003, at 8:49:00
In reply to Re: Nardil + 50mg Amisulpride + 2.5mg Zyprexa safe??? » SLS, posted by ace on December 9, 2003, at 18:54:47
> > I noted your comment in another thread regarding the possibility that higher dosages of Zyprexa are counterproductive. I don't know for sure, but that just doesn't sound right to me. 5mg seems like a good dosage to be sure to glean the optimal antidepressant effect from Zyprexa. I found that Abilify produced a better, albeit brief, antidepressant response. I have no idea as to how well it would work for OCD.
> Scott- this is always something that intrigued me. When I first started Zyprexa 2.5mg quickly set Nardil off in a great way- It really kicked in. However, after nearly 3 weeks of raisng my Olanzapine (up to 7.5mg at one point) I suffered an intractable depression. Ceasing Zyprexa did not help. Highering Nardil did not. I had to LOWER Nardil along with ceasing Zyprexa to recover and regain some AD effect from Nardil.
> A month later I gave Zyprexa another shot to regain the Nardil AD qualities. This time It didn't work, and further, after being at 2.5mg for three weeks, i raised to 5mg for just ONE day...the next day I suffered depression, and had to stop Zyprexa and lower Nardil.
> This is weird.Stranger things have happened. When it comes to the brain and psychotropic meds, I guess anything is possible.
> I really want your opinion on this.
I think Linkage or Shawn T. would be in a better position than me to attack your questions.
> At 5mg Zyprexa would be acting as more as a 5HT and DA AGONIST right?
Zyprexa acts as an antagonist at DA D2 and 5-HT2a receptors. It binds with greater affinity to 5-HT2a than it does to D2. However, it is conceivable that Zyprexa's blocking of serotonin receptors along one circuit could produce a net increase of DA activity in another, especially if it doesn't perfuse into the latter to block the DA receptors there. Location, location, location. It would be an understatement to remark that the brain is extremely complex.
> Someone suggested that the depression stemmed from upregulation of the receptor in response to 5HTa receptor blockade.
I guess such a thing is conceivable (but not necessarily possible) if there were a lag time of one to two weeks between introducing the agent or adjusting its dosage and the appearance of the depressive reaction. It takes about two weeks for receptor function to change in response to exposure to a drug.
> I'm not sure- did too much 5HT cause the depression? Was Zyprexa acting as an ANTAGONIST for DA and 5HT, thereby negating Nardil's actions?
I give up. Just show me what pills to take and how much, then let me be on my way in blissful ignorance.
I wish I could have been more helpful, but I would be lying if I were to tell you that I knew what I was talking about. :-)
Your best guide is probably your own observations of how your unique system reacts to the things you expose it to, and to take notice of associations. It might be a few years yet before medical science can figure out the how and why.
Take care.
- Scott
This is the end of the thread.
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