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Treating the cause of MAOI induced Insomnia?

parnate maoi insomnia

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#1 Hannes2

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Posted 19 November 2017 - 07:23 AM


Hello,

 

some short introduction to the issue: irreversible MAOIs are known for their infamous insomnia as adverse effect. This is especially true for tranylcypromine (Parnate), perhaps as phenelzine (Nardil) comes along with its own sleeping aid as its active metabolite acts on the inhibition of GABA transaminase. From my own experience, any soft interventions like excercise, changing the pattern of taking Parnate, bright light therapy are like sugar pills without significant effect. Over the counter sleeping aids are not too effective either. The MAOI induced insomnia can be effectively knocked out with benzodiazepines and z-drugs, but that's not a long term option. What works wonders are the classic TCAs amitriptyline and nortriptyline as well as trazodone, so that would be either 5-ht2a antagonism already on its own or 5-ht2a antogonism combined with antagonism on the histamine H1 receptor and perhaps also on the alpha-1 adrenergic receptor. The combination of these with MAOIs has been clinically proven as safe and efficient, but it can be still very difficult to get these drugs prescribed as docs have to overcome their fear of serotonin syndrome.

 

So I wonder about the likely cause of the MAOI induced insomnia, like excess norepinephrine/epinephrine? Melatonin? Or a complex interaction of the entire system of monoamin neurotransmitters? Any ideas how one could try to level things out a bit with supplements, diet, drugs?

 

 

 

 

 

 


Edited by Hannes2, 19 November 2017 - 07:28 AM.


#2 YoungSchizo

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Posted 19 November 2017 - 07:54 PM

Although I have some sort of sleep maintenance insomnia but it's not caused by Parnate. I'm on 20mg and take 15/30mg Mirtazapine, that still does the trick.



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