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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Cheryl-Lynn on April 9, 2008, at 19:28:20
I really need some info on what other antidepressants can be taken in conjunction with Parnate - any help would be greatly appreciated.
Cher
Posted by undopaminergic on April 10, 2008, at 5:09:51
In reply to What Other AD meds can you take with Parnate?, posted by Cheryl-Lynn on April 9, 2008, at 19:28:20
It really depends on the dose of Parnate and on the dose of the other medication, and on various factors that vary between individuals - some are more sensitive and may experience serious reactions even to seemingly innocuous combinations, such as a SSRI with selegiline at doses generally regarded as selective for MAO-B (which has no role in serotonin metabolism).
To put it simply, there are two dangers: hypertensive crisis and the serotonin syndrome. The former is caused by substances that drastically elevate extracellular noradrenaline levels, and the latter is caused by serotonin-elevating compounds. Drugs that don't have those effects - directly or indirectly - should be safe, at least in theory.
Due to their noradrenaline-releasing effects, amphetamines taken during MAOI treatment may cause hypertensive crises, and some deaths (surprisingly few) have been reported. On the other hand, with proper caution the combination has been used safely.
All SSRIs and SNRIs are, obviously, potent serotonergic agents, and have high potential for toxicity when combined with MAOIs; deaths have been reported. Unfortunately, most commonly used antidepressants are in this category.
Some tricyclic antidepressants (TCAs) have serotonergic effects - more specifically clomipramine and imipramine (but not others), and combinations with MAOIs have been associated with fatalities.
Other TCAs, specific noradrenaline reuptake inhibitors, dopamine reuptake inhibitors, and combinations thereof seem to be safe (e.g. amitriptyline and bupropion have been tested safely with Parnate), although caution is still recommended.
Anticonvuslants and mood stabilisers should be safe in theory, and combinations of tranylcypromine with lithium have been tried.
Mirtazapine increases noradrenaline release, and although there seem to be no reports of interactions with MAOIs, there is theoretical potential for hypertensive reactions.
Tianeptine seems safe in theory and there are no reports of interactions, but no reports of successful combinations either.
Posted by bulldog2 on April 10, 2008, at 9:00:51
In reply to What Other AD meds can you take with Parnate?, posted by Cheryl-Lynn on April 9, 2008, at 19:28:20
> I really need some info on what other antidepressants can be taken in conjunction with Parnate - any help would be greatly appreciated.
>
> Cher
>
>Deplin is a good choice..Very safe
Posted by Cheryl-Lynn on April 10, 2008, at 19:31:57
In reply to Re: What Other AD meds can you take with Parnate?, posted by bulldog2 on April 10, 2008, at 9:00:51
Thank you for the informative answers.
Unfortunately upon requesting Parnate for my treatment resistant depression of 8 years (I'm Bipolar) with no relief at all, my pdoc agreed but with the stipulation that I must go into the hospital for a minimum of 11 days which was to happen in two weeks during which time I was to slowly start decreasing my meds.
After decreasing my meds for the two weeks my head was MUCH clearer and during which time I found out that the conditions at the hospital where I was to stay were atrocious (and unnecessary to start Parnate), so I refused to go and thus my pdoc dumped me.
I've never had this happen before.
I don't really know what to do.
I do know that I want to have all of my info about Parnate before I see a new pdoc.
Posted by Phillipa on April 11, 2008, at 11:49:50
In reply to Re: What Other AD meds can you take with Parnate?, posted by Cheryl-Lynn on April 10, 2008, at 19:31:57
Oh wow just broosing and saw this how horrible for you. Will you have a problem finding a new pdoc? Phillipa
Posted by Cheryl-Lynn on April 11, 2008, at 17:31:06
In reply to Re: What Other AD meds can you take with Parnate? » Cheryl-Lynn, posted by Phillipa on April 11, 2008, at 11:49:50
I hope not Phillipa.
I've never encountered such a thing - I don't know how other doctors will react to me knowing that my previous doctor dumped me.Cher
Posted by Phillipa on April 11, 2008, at 20:03:03
In reply to Re: What Other AD meds can you take with Parnate?, posted by Cheryl-Lynn on April 11, 2008, at 17:31:06
Do you have to divuldge it? seriously never had a pdoc request files from another pdoc. Love Phillipa
Posted by Cheryl-Lynn on April 12, 2008, at 18:26:53
In reply to Re: What Other AD meds can you take with Parnate? » Cheryl-Lynn, posted by Phillipa on April 11, 2008, at 20:03:03
Yeah, they do here...at least they have thus far.
I feel kind of defeated.
If I requested that they didn't, wouldn't they wonder why?
Posted by Phillipa on April 12, 2008, at 19:52:16
In reply to Re: What Other AD meds can you take with Parnate?, posted by Cheryl-Lynn on April 12, 2008, at 18:26:53
Here the other pdocs have just ignored the request for another docs file. Costs them money to copy and send. Once did have to pay $50 for copies as the doc was leaving town for good. Phillipa
Posted by Cheryl-Lynn on April 12, 2008, at 20:28:53
In reply to Re: What Other AD meds can you take with Parnate? » Cheryl-Lynn, posted by Phillipa on April 12, 2008, at 19:52:16
Not easy to do if you don't have extra $$ eh?
God Phillipa, in my case I have to first get another pdoc and then beg them to go against their colleague's better judgment and prescribe me the meds I want without hospitalizing me.
Posted by undopaminergic on April 13, 2008, at 0:27:29
In reply to Re: What Other AD meds can you take with Parnate?, posted by Cheryl-Lynn on April 12, 2008, at 20:28:53
> Not easy to do if you don't have extra $$ eh?
>
> God Phillipa, in my case I have to first get another pdoc and then beg them to go against their colleague's better judgment and prescribe me the meds I want without hospitalizing me.
>Yes, old medical records are sometimes a problem, but they can also be useful, as they describe symptoms, treatments and results and hence save time that would be consumed by your new doctor having to ask lots of questions that you've already answered. I've found that I can bring copies of old records myself and only show the ones that are useful, factually correct and free from anything detrimental. Also, sometimes I've written my own case history, and included information on treatments (e.g. supplements and drugs ordered from the Internet) that I've tried on my own without a doctor's involvement, but which are every bit as relevant to making decisions on further treatment.
Posted by Cheryl-Lynn on April 13, 2008, at 2:38:32
In reply to Re: What Other AD meds can you take with Parnate?, posted by undopaminergic on April 13, 2008, at 0:27:29
Sounds very useful, especially when you can incorporate some of your own knowledge into your records. You should be able to advocate for yourself in that and every way. In my case, I found out that doing so was threatening to my doctor so much so that I go the ax - never stop advocating for yourself, I say.
Some of the doctors just want you to do whatever they say without question and that's not right.
This is the end of the thread.
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