I’ve been through everything for my Parkinson’s depression and anxiety anhedonia disorder but nothing touches it.
Recently started Rasagiline which I’ve been on for about a month but not feeling anything from it.
Next suggestion from my neuro psychiatrist is moclobimide but I read it doesn’t increase dopamine which I believe is fundamental in my depression given that it tied into Parkinson’s.
is there an argument for taking both of these MAOI together as I’ve read some people have tried without experiencing serotonin syndrome?
I tried to convince the doctor to prescribe pramipexole but they said the side effects are too risky.
I’m just so lost with everything. My Parkinson’s is progressing fast due to not being able to do anything for the depression. My cognition has declined significantly and my working memory has completely gone.
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Schofield81
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Sorry to hear about your unsuccessful efforts to battle depression. May I ask you - do you get sufficient sunlight exposure to trigger serotonin production? Do you know your levels of vitamin D3 ? If not, check out this article
Are you on meds and specifically levadopa? I don’t follow why you are not taking an anti depressant medication. It can take a few tries to get the right one for you.
I have read your post again and think you were asking if rasageline could be taken with other MAO inhibitors. If you are thinking of anti depressants the answer is yes. I investigated this a few years ago. The pt instruction leaflet for the US had a warning wheras for the UK it had no warning - go figure! I also found a drug manufacturer directive that both could be taken at the same time. Vragkatt writing below is correct. Rasageline alone would have only a mild effect. You need something stronger by the sounds of it.
Your dr was right in my opinion about Pramipexole. I know too many people who have had lives ruined by agonists. It seems younger onset are much more likely to have compulsive problems. I’m not sure why you wanted it, I take a small amount. Again it would have only a mild effect on depression. What anti depressants have you tried?
I’ve used 20mg Fluoxetine for decades, now in conjunction with 6mg Ropinirole. It takes about 3 weeks to work. It takes me to a place at which I can usefully engage with CBT. The combination works very well for me. Good luck.
You can try Lithium Orotate. Start with 5mg/day and upgrade gradually week to week if needed. Personally I'm taking 45mg/day with no side effect. Lithium can't be detected in blood test (<0,2 mmol/L). You can search posts about Lithium Orotate on this blog.
As I know the selective MAOI, especially MAOI-A which is the rasagiline does not cause serotonin syndrome. I take rasagiline and venlafaxine together without any problem.
my husband was diagnosed 2 years ago. His tremors were pretty bad. He had a bad reaction to Levadopa/Carbadopa. I started him on Dr Constantini from Italy's protocol for high dose B-1 Thiamine. What a huge difference. Also exercise, and drinking lots of water.
Easy to say, but you can't be depressed. This is the new normal, you have to fight this as you would a home intruder. Exercise will slow the progression. Watch the YouTube videos of before and after that Dr Constantini has posted. Are you taking Magnesium? We take Magnesium L-Threonate. Excellent for mind health.
B1 is an absolute godsend for me. When I stop taking it, I consistently start losing my ability to recall words and converse normally, I have no energy or motivation, and I become apathetic and depressed. The only symptom I have that it doesn't ameliorate is tremor (I use mucuna for that). I realize it doesn't seem to work for everyone, but I wish everyone would give it a good, long try. I can't believe how quickly I start to deteriorate if I stop taking it (I've experimented quite a few times because I thought maybe it wasn't really helping as much as it seems to be).
how much sublingual are you taking and do you hold the saliva under your tongue for 30 minutes before you swallow. It took me 3 months to find my sweet spot but it has given me my life back. Have you read Daphne Bryan’s book and follow her protocol. good luck
Could be worth a try. Ketamine has been shown to work when multiple anti-depressants haven't helped. That said, I take Rytary and Memantine. I didn't know they were in the same class. I had 'brain fog' and the doctor added memantine to my Rytary. I feel a bit more clear-headed with this drug. That is, I can complete difficult crosswords more easily now.
I’m so sorry that you’ve got to this stage, but at least you are reaching out. We are so lucky to have this site.
It seems lots of your symptoms are non motor, as my husband Alan’s are. So I thought I’d tell you what we have done. We had amazing success with mannitol, see my post. The improvements lasted from 2019 till 2021. It’s worth a try. His PD was diagnosed in 2013.
Alan has a very difficult time since the end of 2022. He ended up in hospital with delirium. He was put on two antidepressants, Escitalopram and Mirtazapine. They certainly have worked well together. He still managed to have two more episodes of Delirium, but very mild compared to the first one. His mood is much better.
We have purchased the Wellred Coronet and their Therapad. Very recently we got their CoraNase, which sits in the nostrils and sends Infrared light up to the brain. Since then he’s got his sense of taste and smell back. He lost them very early after his diagnosis. He’s now enjoying his food again. Our neurologist has said that the research into the coronet and Therapad was done here in Australia by a team led by a very highly regarded scientist. Some of his patients have used the coronet with success. He hasn’t recommended using it, but certainly approves.
Re serotonin syndrome, we had a situation where the hospital Alan was in told us that Alan needed to go off a drug because of the risk of this syndrome. The drugs were Escitalopram and Xadago. Our GP disagreed and when I checked interactions on line, it stated that there was low risk, in fact very rare.
Re B1, have you read Daphne Bryan’s book, available on Amazon. She has a Facebook page and is a member on this site. You need to work pretty hard to get the right dose. We tried it earlier, but it sent Alan’s already high blood pressure through the ceiling. Since then , his blood pressure has returned to normal, so we will try again. He started using high dose vitamin C for his constipation, as suggested by park_bear on this site. I then read about the results of a trial on Vitamin C for high blood pressure which reported a drop in blood pressure in participants who suffered from high blood pressure. The vitamin C had no effect on participants with normal blood pressure. I’m assuming the Vitamin C has settled his blood pressure.
I hope some of the advice you’ve received from our members will give you hope.
I have a cognitolite device I wear on my head twice daily but doesn’t seem to make much difference. How much do the intranasal devices cost? Yes I’ve read daphnies book and trying mannitol too
Did your doctor give specific reasons why pramipexole would be too risky for you as an individual or does he just have a general prejudice against it? If the latter, I would change doctors
Surely you just stop taking the pramipexole if you have that side effect. (Is he protecting himself or treating you as if you are stupid). My husband was put on the Neupro patch (same possible side effect) when Madapar didn’t seem to anything early on. The improvement was dramatic, to the point that his diagnosis was changed from Lewy Body dementia to PD. He’d actually had severe apathy, which totally disappeared.
Our neurologist has had patients who got the impulsive behaviour side effect and has had to take them off it. He monitors his patients very closely.
See the Wellred site for info on the coronet. The price of the coronet is USD$795. There are a couple of videos on You Tube. They were also put on this site by members. When Alan was in hospital last year the geriatrician mentioned a hand held device he’d seen work. When I investigated it, it turned out to be the same technology, but was $2000, SYMBYX out of Sweden.
I was hoping mannitol might work for you. I guess you took the suggested dose of 1tbs. in coffee.
my husband with PD is experiencing more dementia and tremors and is on Rivastigmine and Mirapex. Low doses so maybe a higher dosage will help. However the Neuro doc said the Riva would not stop the dementia but slow it down…..not seeing much slowing. Of course my husband will be 86 in Oct. so that probably plays into the situation.
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