6 replies to this topic

[jaiho]

So, someone suggested this stack.

 

Moclobemide is an MAO-A Reversible MAOI.   x2 150MG a day

Selegiline is an MAO-B Irrevisible MAOI.  no more than 5mg orally

Tianeptine is a SSRE, Selective Serotonin Reuptake Enhancer   3x 12.5mg a day

Agomelatine is a Melatonin agonist, increasing Dopamine & norepinephrine in the frontal cortex, and puts you to sleep faster (Counters the insomnia of Moclobemide)   1x 25mg, or 50mg before bed

 

Stimulating, euphoric. However doses have to be watched so as not to induce a hypertensive episode.

 

The Agomelatine is optional, it's expensive but its necessary to counter the insomnia i get from Moclobemide.

 

As usual your mileage may vary and i'd do your research yourself before trying this combo

Edited by jaiho, 22 July 2014 - 11:36 AM.

[Tom_]

This is unneassrily dangerous and involves more drugs than are needed.

 

If you are taking both Selegiline and Moclobremide you might as well just take a full MAOI. However since Selegiline at doses lower than 10-12mg has no antidepressant effect as MAO-B inhbitors aren't antidepressive you might as well take Moclobremide alone.

 

The risk of a hypertensive episode on Moclobremide and Selegiline is very low  provided you are observing a strictly low-tryamine diet and not taking stimulants.

 

There is very little evidence that Tianeptine is an SSRE and plenty stacked against it. Its more likely to work by modulating glutemate and there by increasing synaptogenesis. There is only a singe case study suggesting Tianeptine is of any use combined with an MAOI and multiple other drugs (topiramate, trazodone and ziprasidone). Although it appeard safe.

 

There are plenty of sedative antidepressants/agumenters with better evidence that Agomelatine and that have been used alongside MAOI's providing some evidence for safety. Atypical antipsychotics in low to medium doses (particually Quetiapine), a few should be avoided due to SSRI activity like Ziprasidone. Trazadone is very commonly used alongside MAOI's. Its sedative and an approved antidepressant. Doses above 150mg must be avoided as it develops significant SSRI activity above these doses. Mirtazapine is also a good option. The benefit of Trazadone or Mirtazapine is that they are both potent antagonists of Serotonin and add a respected pharmacological antidepressant mechanism. The same can be said for the atypical antipsychotics. Trimipramine is also another reasonable option.

 

Phenazline and Tranylcypromine both tend to either have sedative or at worst non-stimulant effects.

 

An effective combination could be Tranylcypromine 20-40mg/Phenalzine 15-60mg and Quetiapine 150-300mg xl (I'm currently on Tranylcypromine 40mg and Quetiapine 300mg xl and 50mg short release) or Mirtazapine 30-45mg. Of course its quite possible, as Tranyclypromine/Phenlazine has been shown to be particually effective in treatment resistant depression, that that alone would be effective.

Edited by Tom_, 23 July 2014 - 01:09 PM.

[jaiho]

The benefits of this combo are from the lack of side effects. Full MAOI inhibition (Parnate, Nardil) has nasty withdrawal effects, as well as a strict diet required.

Moclobemide does not have a diet restriction, with adding low dose Selegiline, the MAO inhibition is not strong enough to require a tyramine restricted diet.

The reason for Selegiline is more for a nootropic than an anti depressant effect, with its life prolonging properties and reducing dopamine receptor decay with aging.

 

It's true the MoA for Tianeptine is still largely unknown, i was just putting up what class its under

 

Agomelatine has no side effects whatsoever, while the sedating style drugs you'd feel rather groggy during the day.

 

The point of this stack is maximum anti depressant potential with lack of side effects, withdrawal. As long as doses are adhered to.

 

 

Edited by jaiho, 23 July 2014 - 10:04 PM.

[VICREP]

Jaiho,

 

I'm intrigued by this combination. I'm contemplating taking similar stack to treat anhedonia, apathy, social anxiety, and low mood.

 

Were the effects sustainable? How long did you take it? How was it coming off?

[magniloquentc0unt]

haha, interesting find i search for some insane combos and 1 out of 2 times i find apost by you jaiho

i was thinking of selegiline + valgoxan: do you have any experience with just those 2?

[YoungSchizo]

Jaiho, don't get me wrong, don't want to High-Jack, you may even have advise for me.


I'm on Parnate 20mg for depression, it helps against suicide ideation. Anything higher and I get positive symptoms (also on just 20mg I never had to watch my diet). Mirtazapine 15mg for sleep, anything higher I get hypomanic due to the strong interaction with Latuda and 2.5mg Zyprexa which causes another interaction with Latuda (night sweats).
I actually want to keep Parnate, Latuda and Mirtazapine in my stack. Or drop at least Mirtazapine for a alternative sleep aid like Trazadone. My goal is to cure my sleep maintenance insomnia and night sweats. However I think I need a much higher dose of (150 mg) Trazadone to put and keep me at sleep.

Is this combo safe: Latuda 40mg, Parnate 20mg, Mirtazapine 15mg, Zyprexa 2.5mg + 150mg Trazadone?

Or

This combo: Latuda 40mg, Parnate 20mg, Zyprexa 2.5mg + a higher dose than 150mg Trazadone?

Or

This combo: Latuda 40mg, Parnate 20mg, Zyprexa 2.5mg + (fill in a potent sleep aid)?

[John250]

What did you notice from Tianeptine? I have some that I have been anxious to use but I just started back on Lexapro and I’m not sure how they will counteract.

Edited by John250, 01 June 2018 - 08:29 PM.