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Discussion Starter · #1 ·
How safe are these meds with Nardil?

Hi!

I'm currently on 45mg Nardil a day, along with 1.5mg Klonopin a day. My pdoc is a totol idiot and won't prescribe me ANYTHING against my insomnia and weight gain. All i got was Zopiclone, but I'm already addicted to Klonopin as it is, so I won't touch that **** :(

What she doesn't know however, is that I see a private pdoc from time to time :) And I have a meeting with him in just a few weeks. And he prescribes almost anything.

So, here's a list of meds that comes to mind that I'm willing to try along with Nardil. IF they are SAFE that is.

For sleep:
Mirtazapine 7.5mg (Has the famous 5HT1A agonism)
Quetiapine 12.5mg (Is apparantly serotonergic, according to my pdoc)
Promethazine (Not sure about the dosage yet)
Propiomazine (Not sure about the dosage yet)
Hydroxyzine (Not sure about the dosage yet)

For weight gain and sexual side effects:
Wellbutrin 300mg (dopaminergic of course)

For weight gain:
Metmorfin (Don't know any dosage here as I haven't tried it before.)

More suggestions are very welcome of course!!

Many many thanks in advance!!

/Fredrik
 

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Hydroxyzine/Atarax should not be used while on MAO according to Swedish textbook.

Wellbutrins effect on Dopamin is argumentable. And should perhaps be more considered an NRI.
 

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Discussion Starter · #4 ·
Thanks!

Does anybody have ANY info regarding Mirtazapine and Quetiapin combined with Nardil?

This would be very very helpful to me.

I got this answer in another forum regarding the same post "Right off the top, I can see Phenelzine is contraindicated with Bupropion."

/Fredrik
 

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I tried Mirtrazapin for sleep while on MAOi Parnate... It had some sedating effect that lasted the day after.
 

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Discussion Starter · #6 ·
So Mirtazapine is also "fairly" safe then with Nardil you could say? Can I ask your Mirtazapine and Parnate dosages at the time?

/Fredrik
 

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First of all, all the meds you listed are safe (be cautious if adding Wellbutrin). However there are some complicating factors:

Mirtazapine 7.5mg (Has the famous 5HT1A agonism)
...
For weight gain and sexual side effects:
Wellbutrin 300mg (dopaminergic of course)
These two are fine. However they are - at least in the U.S. - officially contraindicated.

In the U.S., pharmacies can check your medication history even at other pharmacies to look for interactions (and cause no one thinks privacy exists any more... another topic :mum).

I once filled Parnate at one pharmacy and Wellbutrin at another. The pharmacist filling the Wellbutrin had been given no record - by me - of any other medications. That was on purpose because I got tired of re-re-reexplaining that my combo was safe. BUT she freaked out anyway because it still showed up on her computer. Probably showing a skull and crossbones and the words "DEATH IMMINENT" scrolling across the screen, so she called my doctor and it was a big mess.

In Sweden it may be different. However, it may not. Be prepared for an uncomfortable set up. It is usually better to have one prescriber handle both medications.

Having said that, here are my thoughts:

Mirtazapine 7.5mg (Has the famous 5HT1A agonism)
This is just fine. You could even push up the dose as an augmenter if you felt like it. Mirtazipine has no SRI activity so it is safe.

However I think since it is an alpha-2 antagonist, it may potentiate orthostatic hypotension. (I think???) In otherwords you may feel dizzier and more tired. My armchair guess: 3/5 stars.

Quetiapine 12.5mg (Is apparantly serotonergic, according to my pdoc)
Hmm interesting. I think my first choice as an option.

It is mostly an antihistamine and alpha-1 [norepinephrine receptor] antagonist. It is serotonergic on receptors; I don't think it is a reuptake inhibitor, so it is safe. In moderate doses it becomes a norepinephrine reuptake inhibitor! May increase orthostatic hypotension; however, hopefully it's mostly worn off by noon or so.

It is a D2 antagonist, and even very low doses will have a tiny bit of activity. It could interfere with Nardil's effectiveness. (If it's only just brushing those receptors you may get activity simply at autoreceptors. So you would actually increase dopamine levels. Hmm.) You would just have to see.

My armchair guess: 4/5 stars if tolerated.

Promethazine (Not sure about the dosage yet)
Antihistamine and D2 antagonist. Good for combining with codeine in cough syrup and then sleeping a bunch.
My armchair gues: 1/5 stars

Propiomazine (Not sure about the dosage yet)
My thoughts probably the same as promethazine since they look similar. But otherwise I don't know much about this drug.

Hydroxyzine (Not sure about the dosage yet)
In many ways very nice. Likely to be prescriber-friendly. Mostly antihistamine w/ 5HT2A antagonism. There is some D2 and alpha-1 antagonism (generally bad things) but I think at a low-ish dose they wouldn't kick in too much. Just speculating there.

However it has a long half-life. You might be drowsy all the next day.

My armchair guess: 3/5 stars

Other ideas for insomnia: trazodone, melatonin, agomelatine, diphenhydramine, meclizine

For weight gain:
Metmorfin (Don't know any dosage here as I haven't tried it before.)
Yeah, maybe w/ Nardil. If you can stick to a low-sugar, or no-sugar, diet, you may not need it. If that's just NOT happening (due to appetite increase or maybe it's just too expected in your family/social circle, whatever) then you can ask about it.

I have tried it. Super gassy, at first. Increase the dose SLOWWWWLY.

Wellbutrin 300mg (dopaminergic of course)
Titrate slowly (37.5 mg 1st day, increase by this amount each day; take blood pressure before and 90 minutes after dose).

A lower dose may be all that's needed. It is mostly an NRI. I remain stubbornly convinced that it has some dopaminergic activity even though this is unresolved in the research literature.

IMHO it works quite well if you have hypotension and fatigue.

BTW... Make sure to get B6 supplements on Nardil. You probably already know that. It just popped into my head. Nardil decreases B6.

____

Personally, for insomnia I mainly take alprazolam, melatonin, or an antihistamine. I used to take zolpidem, but it wasn't that effective.
 

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yeah we have something called caretec i think, so just enter your birthnumbers and a list comes up on all meds, not sure about chart/journals, but i bet they can read them to... Usually they ask if its ok, but when you sitting in their office... Its like ok sure... I locked my chart 4 times.
 

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Discussion Starter · #11 ·
Hi!

Thanks for all the ansers! I will meet my privave pdoc todyay. Mirtazapine with Nardil is nothing but a big JOKE to me. Doesen't work at all :( Mirtazapine DID howevever work with Dexedrine for some reason,

Will be askning for Sweoquel and hope for the better. Let you know in a sec.


But does lower doses ONLY affect the D2 auto-receptors? Can somebody PLEASE explain this to me???? :) I have heard this this with other meds too. That avery a low dose only affect the aotu-receptor. But what does this mean in reality?
What happen with the REAL receptor for instance. Has this something to to with the downregulation?

/Fredrik
 

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Hi!

Thanks for all the ansers! I will meet my privave pdoc todyay. Mirtazapine with Natdil is nothing but a big JOKE to me. Doesen't work at all :(

Will be askning for Sweoquel and hope for the better. Let you know in a sec.

But does lower doses ONLY affect the D2 auto-receptors? Can somebody PLYEASE explaint this to me???? :) I have heard this tith other med too. That very a low dose only affect the aotu-receptor. But what does this mean in reality?
What happen to the REAL receptor for instance. Has this something to to with the downregulation?

/Fredrik
By blocking the pre-synaptic autoreceptor it will increase Dopamine output.
But this is more commen on drugs like Solian/amisulpride...

But for Seroquel:
Blocks serotonin 2A receptors, causing enhancement of dopamine release in certain brain regions and thus reducing motor side effects and possibly improving cognitive and affective symptoms
http://stahlonline.cambridge.org/pr...erapeutics&name=Quetiapine&title=Therapeutics
 

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Discussion Starter · #13 ·
Thanks for the answer!

But can you, in more detail, elaborate just WHY certain medicines dopamine receptors, and in this case, seroquel, WON'T be affected in LOW doses.

And WHAT are the auto-receptors role in this case? Aren't they down-regulated with low does?

WHAT happens when you take a LOW dose conter a medium dose?


Please bare with me on this one :) But this is IMPOTANT stuff to me :)


And I have REALLY great news regarding the Nardil regiemen for all of you following this!
I will update this tomorrow I think! It was something that I was not thinking of.


/Fredrik
 

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Thanks for the answer!

But can you, in more detail, elaborate just WHY certain medicines dopamine receptors, and in this case, seroquel, WON'T be affected in LOW doses.

And WHAT are the auto-receptors role in this case? Aren't they down-regulated with low does?

WHAT happens when you take a LOW dose conter a medium dose?

Please bare with me on this one :) But this is IMPOTANT stuff to me :)

And I have REALLY great news regarding the Nardil regiemen for all of you following this!
I will update this tomorrow I think! It was something that I was not thinking of.

/Fredrik
Sorry don't know that like the back on my hand,thus turn to literature. But it's 3:30am here as you probly know ;). So i don't have the energy.

Here is an interessting book from Stahl that adresses it on like p32 and 152and forward, i recomend you check it out, it also has pictures that illustrates how it works.

http://www.scribd.com/doc/200719035/Stahl-s-Essential-Psychopharmac-Stahl-Stephen-M
 

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Hi!

Thanks for all the ansers! I will meet my privave pdoc todyay. Mirtazapine with Nardil is nothing but a big JOKE to me. Doesen't work at all :( Mirtazapine DID howevever work with Dexedrine for some reason,

Will be askning for Sweoquel and hope for the better. Let you know in a sec.

But does lower doses ONLY affect the D2 auto-receptors? Can somebody PLEASE explain this to me???? :) I have heard this this with other meds too. That avery a low dose only affect the aotu-receptor. But what does this mean in reality?
What happen with the REAL receptor for instance. Has this something to to with the downregulation?

/Fredrik
you take nardil since how manhy time ? Clonazepam and nardil are good for your SA, if I understood ?

You just search to sleep : Mirtazapine is good with these drugs butyou tried and there is no effect ? how many days you keep it ?
 

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Discussion Starter · #16 ·
you take nardil since how manhy time ? Clonazepam and nardil are good for your SA, if I understood ?

You just search to sleep : Mirtazapine is good with these drugs butyou tried and there is no effect ? how many days you keep it ?
I tired Mirtazapine together with Nardil for atleast 3 weeks! Slept aweful. Some nights just 2-3 hours. Woke up a lot in the midde of the nights.

I tried Mirtrazapine both 15mg and 7.5mg.

The lower the dose, the more Mirtzapine is effective for sleep. The other way around for depression.

Unfortunately, not THAT many people know about this. Well, you shouldn't go UNDER 7.5mg, that wouldn't make no sense :) That's just TOO litte.
THis IS how Mirtazapine works.

/Fredrik
 
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