[imported_ace]

Here is a litle history. December 2002 I started Nardil (Phenelzine). 6 weeks on this and it took effect. Brilliant for depression and phobic anxiety. My OCD needed a bit more help but. I decided to try Clomipramine (after 10 day washout from Nardil)...big mistake. It caused a severe (vegetative) depression within 4 days. Normally I would have stuck it out but I was at uni so, after 2 days, I restarted Nardil. Then ensued a moderate serotonin syndrome. Never ever will I do anything like that again.

Once I restarted Nardil, within a week, I was euphoric. But this waned. After about another 3 weeks of feeling OK, it kicked in again (at 90mg by now). This only lasted 5 or so days then I felt average again.

With 90mg Nardil I started 2.5mg (raising to 7.5mg) Olanzapine nocte. Within 4 days of this regime...Bang! Brilliant effects! But again this waned. But it did last 25 days or so. Then not only did it stop, but I started to feel incredibly depressed. I attributed this to Olanzapine working against Nardil (even though at such a low dose it is ment to act like an 5-HT and DA agonist). Stopping the Zyprexa didn't help. I felt worse and worse. I upped the dose to 120mg at one point. No help. Eventually relief was found by DROPPING the dose. I stayed low for a while and, reasoning that Olanzapine actually probably helped before, restarted it at 2.5. After 2 weeks or so, depression returned- I instantly lowered my dose of Nardil but kept Olanzapine (it's great for one subset of OCD I have). I decided to make a clean break, and start Parnate.

I believe the big mistake was to stop Nardil in favour of Clomipramine. After all, Nardil was brilliant until I did the switch and then the problems ensued.

However, and this is my question (s), do you believe the Zyprexa caused the depression? If so, I want to get off it, cause theoretically it will stop the Parnate from working.

Would the Zyprexa, even at 2.5, would negate the Parnate therapeutic action? I've only ever heard of great responses from MAOI + atypical. (granted the atypical is kept low dose)

I've been on Parnate 5 days now. (now at 30mg ) It has already helped phobic anxiety a lot, but hasn't touched the depression. In fact, yesterday I was very depressed (caused by Parnate?). Today I am less depressed but feel very flat, moreso than before I started the Parnate. How long before it would kick in do you think?

I thank you so much for any answers you can give me and try to make sense of my situation.

Ace.

[heidu]

I can't help you here but I feel the need to ask. Are you seeing a qualified professionsl who is helping you with your medicine cocktails?
Alot of people get a "buzz" for a bit when an antidepressant kicks in but that buzz doesn't not stay.
I am concerned. It doesn't sound healthy.
Heidu

Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending. ~ Carl Bard ~

[imported_ace]

I can understand your concern and appreciate it. I am seeing a regular MD. I have had very bad experiences with psychiatrists and will never see one again. I also am soon to enter medical school myself as a postgraduate. You might ask "Shouldn't I know these answers then?". Unfortunately I don't. I HAVE studied psychopharmacology (sometime ago now) but not to a great depth.

Also, I am not taking medications for a short term buzz- I have depression, multiple anxiety disorders. I have no interest in any kind of psychotherapy. Not only have I come to have a philosophical disagreement with it, but it actually made my problems much worse in the past- like scratching at a wound. But that's just my opinion.

I use as little meds as possible to get the job done. I choose the MAOIs for their great safety record (apart from hypertensive problems) over many, many years. And their efficacy.

Thank you for responding,
Ace.

[CamW]

ace - Clinically, I have not found that Zyprexa™ (olanzapine) causes or exacerbates depression to any appreciable effect, but it can cause some side effects that are similar to the effects of depression itself, especially in the first few weeks of use. Start-up side effects of Zyprexa include somnolence, agitation, nervousness, hostility, and insomnia, but these usually disappear, or at least lessen, within 2 to 4 weeks after starting the drug.

I have seen Zyprexa and Nardil™ (phenezine) used together. I am not aware of a reason not to use them together (but there may be a reason .... my memory is not so great of late).

Dosing of the two drugs, when used together varys very widely in different individuals. Without knowing you, I would not be able to even hazard a guess as to what dose would be right for you.

As for the euphoria at the re-starting of Nardil could be due to a couple of things. If you didn't wait 2 weeks after stopping clomipramine (Anafranil™) to start the Nardil, you could have been experiencing a mild serotonin syndrome, caused by an interaction between these two drugs.

The second possible reason for the euphoria may have been just a weird start-up side effect of the Nardil. This is only a guess. Several antidepressants can initially cause euphoria as a start-up side effect, and when it does happen it seems to occur 4 to 7 days after starting the Nardil. These feelings seem to resolve just as quickly (as seen in your case).

A third way that Nardil can cause euphoria is when it is taken for the treatment of the depression phase of a person with undiagnosed bipolar disorder. Nardil does cause something called "manic-switch" in these people. It seems that relieving the depression in bipolar disorder can cause the person to switch from the depressive phase to the manic phase in a person with bipolar disorder.

Sometimes when one stops taking an antidepressant (or lithium) that was working, it seems to take longer for the antidepressant effects to kick-in (4 to 8 weeks, instead of the 2 to 4 weeks when initially starting the drug.

I hope that this is of some help. - Cam