Hey all.
I do not consider social anxiety to be the crux of my problem, it is more chronic anergic bipolar II depression. BUT I like this forum due to the MAOI expertise here.
I personally ended up interested in MAOIs just by looking through everything on PubMed on treatment resistant, Bipolar depression. I just tallied it up and I have been on 11 different meds for depression / bipolar, OK lithium and lamictal only count partially as antidepressents but in some people they offer good prophylaxis. I am only counting Wellbutrin once even though I have been on it 6(!) times at doses up to 750mg / day.
I was very impressed on how MAOIs performed in the literature. Their superiority was obvious. And I find all sorts of patients that offer very positive MAOI experiences. In contrast, the ignorance of doctors, and their reliance on pharma company salesmen to spoon feed them information, is appalling.
Now I say I *hope* to go on Parnate, my Dr. hasn't approved it yet. But I think the odds are good, he is very open to listening to what I have to say. After I found out about low dose, sublingual ketamine I researched it and discussed my findings with him. Pretty soon I head to the compounding pharmacy and picked up my syringe and bottle. I feel pretty lucky that I actually get to do this sort of thing, even if Ketamine hasn't proved a silver bullet for me.
My current med cocktail is lithium, lamictal, wellbutrin and ketamine. Low side effects and it helps with some of my symptoms, I have been free of suicidal ideation. But I want a complete remission damnit and chronic symptoms are very stubborn. I would say my most problematic symptoms are anhedonia, anergia, and a lack of motivation and drive.
I had a temporary but grand remission on lamictal. I think it was probably psychogenic (placebo) but nonetheless, living for even a week without depression symptoms is like a revelation. It has motivated me to pursue treatment aggressively. When you have chronic depression (dysthymia) it is hard to know what you are missing because the symptoms can be so pervasive.
I have a few questions if anyone cares to hazard a guess:
1. Is there any difference between brand name and generic Parnate? I am strongly inclined to believe that people are just being paranoid when they say that they experience a difference. A lot of people complain about the "new" Nardil but they are a self selected sample and I am curious how many of the people that complain were aware of the change before they experienced treatment failure.
2. I am a little excited about the combination of ketamine + Parnate... not for any recreational purposes but just because it seems like such a good roundup of effective mechanisms of action. The whole hog of NMDA antagonism and biogenic amine amplification. Neurogenesis and a rapid increase in dendrite growth. Two very potent neuroprotective agents working together (hopefully).
It seems pretty safe but I find myself unable to figure out what the combo will do, or what I should expect. I know that NMDA antagonists seem to "reset" tolerances to various drugs, and/or potentiate them. This isn't just recreational drug users who have noted this but clinicians as well. I myself have noted greater potency from tobacco of all things shortly after I use ketamine.
Potentiating a simple drug is easy to understand. But Parnate does SO much. I have seen numerous papers that argue that the full therapeutic action of Parnate is not accounted for by its MAOI action, there are trace amines, there is the supposition that it has an amphetamine-like effect. Although I have seen a lot of people repeat this amphetamine hypothesis it isn't supported in the literature, by the way.
SO - here is the million dollar question: what would you expect from mixing the two drugs? Lower doses of Parnate needed? A more activating effect profile? Lower side effects? I know no one can answer this question authoritatively, BUT this is the best place on the internet to ask this question.
3. Final question for the people here who are already on MAOIs - would you add in Ketamine if you could? Why or why not?
I do not consider social anxiety to be the crux of my problem, it is more chronic anergic bipolar II depression. BUT I like this forum due to the MAOI expertise here.
I personally ended up interested in MAOIs just by looking through everything on PubMed on treatment resistant, Bipolar depression. I just tallied it up and I have been on 11 different meds for depression / bipolar, OK lithium and lamictal only count partially as antidepressents but in some people they offer good prophylaxis. I am only counting Wellbutrin once even though I have been on it 6(!) times at doses up to 750mg / day.
I was very impressed on how MAOIs performed in the literature. Their superiority was obvious. And I find all sorts of patients that offer very positive MAOI experiences. In contrast, the ignorance of doctors, and their reliance on pharma company salesmen to spoon feed them information, is appalling.
Now I say I *hope* to go on Parnate, my Dr. hasn't approved it yet. But I think the odds are good, he is very open to listening to what I have to say. After I found out about low dose, sublingual ketamine I researched it and discussed my findings with him. Pretty soon I head to the compounding pharmacy and picked up my syringe and bottle. I feel pretty lucky that I actually get to do this sort of thing, even if Ketamine hasn't proved a silver bullet for me.
My current med cocktail is lithium, lamictal, wellbutrin and ketamine. Low side effects and it helps with some of my symptoms, I have been free of suicidal ideation. But I want a complete remission damnit and chronic symptoms are very stubborn. I would say my most problematic symptoms are anhedonia, anergia, and a lack of motivation and drive.
I had a temporary but grand remission on lamictal. I think it was probably psychogenic (placebo) but nonetheless, living for even a week without depression symptoms is like a revelation. It has motivated me to pursue treatment aggressively. When you have chronic depression (dysthymia) it is hard to know what you are missing because the symptoms can be so pervasive.
I have a few questions if anyone cares to hazard a guess:
1. Is there any difference between brand name and generic Parnate? I am strongly inclined to believe that people are just being paranoid when they say that they experience a difference. A lot of people complain about the "new" Nardil but they are a self selected sample and I am curious how many of the people that complain were aware of the change before they experienced treatment failure.
2. I am a little excited about the combination of ketamine + Parnate... not for any recreational purposes but just because it seems like such a good roundup of effective mechanisms of action. The whole hog of NMDA antagonism and biogenic amine amplification. Neurogenesis and a rapid increase in dendrite growth. Two very potent neuroprotective agents working together (hopefully).
It seems pretty safe but I find myself unable to figure out what the combo will do, or what I should expect. I know that NMDA antagonists seem to "reset" tolerances to various drugs, and/or potentiate them. This isn't just recreational drug users who have noted this but clinicians as well. I myself have noted greater potency from tobacco of all things shortly after I use ketamine.
Potentiating a simple drug is easy to understand. But Parnate does SO much. I have seen numerous papers that argue that the full therapeutic action of Parnate is not accounted for by its MAOI action, there are trace amines, there is the supposition that it has an amphetamine-like effect. Although I have seen a lot of people repeat this amphetamine hypothesis it isn't supported in the literature, by the way.
SO - here is the million dollar question: what would you expect from mixing the two drugs? Lower doses of Parnate needed? A more activating effect profile? Lower side effects? I know no one can answer this question authoritatively, BUT this is the best place on the internet to ask this question.
3. Final question for the people here who are already on MAOIs - would you add in Ketamine if you could? Why or why not?