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20mg Parnate. Can I add another antidepressant?

parnate depression

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#1 YoungSchizo

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Posted 27 January 2018 - 12:52 PM


Hey guys,

I'm stuck with 20mg Parnate. It's a good antidepressant, especially against suicidal ideation though I'm unable to raise the dose. Tried to raise it 4 times, 4 times with different "tactics"
But it aggravated hallucinations so I'm unable to get it's full antidepressant benefits. On 20mg I do not have food restrictions though my negative/depression symptoms are still severe. Is it dangerous to add another antidepressant to my regiment? (I'm also taking 15mg Mirtazapine but it did not provoke any problems, also on 30mg)

#2 UltraMagnus

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Posted 27 January 2018 - 06:39 PM

I took agomelatine with phenelzine, can't say it helped a great deal, but may be worth a try.



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#3 Tom_

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Posted 30 January 2018 - 01:20 AM

Certain antidepressants are safe with Tranyclypromine but are rarely advisable. If you are having aggrevated hallucinations it seems fair to assume you have a psychotic disorder. In which case adding certain atypical antipsychotics - Olanzapine, Aripriprazole, Amisulpride or (if Bi-polar) Quetiapine all have good evidence bases for depression in Bi-polar and to a lesser extent in Schizophrenia. If you have Bi-polar Lithium and Lamotragine can be considered.



#4 YoungSchizo

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Posted 30 January 2018 - 09:42 AM

I took agomelatine with phenelzine, can't say it helped a great deal, but may be worth a try.


Were you on a (high) therapeutic dose of phenelzine while adding Agomelatine?

#5 YoungSchizo

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Posted 30 January 2018 - 09:56 AM

Certain antidepressants are safe with Tranyclypromine but are rarely advisable. If you are having aggrevated hallucinations it seems fair to assume you have a psychotic disorder. In which case adding certain atypical antipsychotics - Olanzapine, Aripriprazole, Amisulpride or (if Bi-polar) Quetiapine all have good evidence bases for depression in Bi-polar and to a lesser extent in Schizophrenia. If you have Bi-polar Lithium and Lamotragine can be considered.


I have schizophrenia. Since 20mg Parnate isn't even considered a high/therapeutic dose I was wondering if I should worry about evoking a serotonin-syndrome when adding another antidepressant.
With trying different "tactics" I mean upping dosages of the antipsychotics (I'm on Zyprexa and Latuda) and try to raise Parnate again, unforunately with no avail, 20mg is the max dose I'm able to tolerate.

So, Agomelatine and Notriptyline are on the list. Other suggestions?

P.s. even though I'm not getting it's full antidepressant benefits I actually want to stay on Parnate since it's also somewhat antipsychotic on 20mg. Meaning it also helps especially on thought disorder like symptoms.

#6 UltraMagnus

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Posted 31 January 2018 - 03:54 PM

 

I took agomelatine with phenelzine, can't say it helped a great deal, but may be worth a try.


Were you on a (high) therapeutic dose of phenelzine while adding Agomelatine?

 

 

60mg, which is officially the maximum here.



#7 Hannes2

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Posted 04 February 2018 - 03:38 PM

You can add pretty much anything (carefully!) to your regime other than a potent serotonin reuptake inhibitor (even at 20 mg). Here's a list of "safe drugs" (other than nortriptyline and amitriptyline) to combine with MAOI from Ken Gillman:

 

Mirtazapine, mianserin, doxepin (now re-badged — correctly — as an anti-histamine-type ‘hypnotic’), trazodone, nefazodone, buspirone, bupropion, reboxetine, atomoxetine, amoxapine, agomelatine, tianeptine.

Lurasidone, quetiapine, aripiprazole, olanzapine, asenapine, and all other neuroleptics.

 

Methylphenidate (it is not a 5-HT releaser or uptake inhibitor), amphetamine (it is a releaser, but may be used cautiously, ‘start low, go slow’ is the mantra to remember), the new preparation ‘lisdexamfetamine’ may be an advantage owing to its better pharmaco-kinetic profile.

 

Lithium, carbamezepine, valproate, lamotrigine.

 

L-tryptophan

https://psychotropic...ping-combining/


Edited by Hannes2, 04 February 2018 - 03:39 PM.


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#8 YoungSchizo

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Posted 06 February 2018 - 12:43 PM

You can add pretty much anything (carefully!) to your regime other than a potent serotonin reuptake inhibitor (even at 20 mg). Here's a list of "safe drugs" (other than nortriptyline and amitriptyline) to combine with MAOI from Ken Gillman:

Mirtazapine, mianserin, doxepin (now re-badged — correctly — as an anti-histamine-type ‘hypnotic’), trazodone, nefazodone, buspirone, bupropion, reboxetine, atomoxetine, amoxapine, agomelatine, tianeptine.
Lurasidone, quetiapine, aripiprazole, olanzapine, asenapine, and all other neuroleptics.

Methylphenidate (it is not a 5-HT releaser or uptake inhibitor), amphetamine (it is a releaser, but may be used cautiously, ‘start low, go slow’ is the mantra to remember), the new preparation ‘lisdexamfetamine’ may be an advantage owing to its better pharmaco-kinetic profile.

Lithium, carbamezepine, valproate, lamotrigine.

L-tryptophan

https://psychotropic...ping-combining/

Thanks for the list Hannes2!!





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