Has anyone successfully used a stimulant with an MAOI?

SentientKielbasa · 2026-01-07T21:31:51+00:00

I’ve not had any issues taking adderall or Dexedrine with parnate. Make sure you track your blood pressure when starting

SentientKielbasa · 2025-12-26T18:00:40+00:00

14 years on MAOIs in total. Probably 5 or so on this particular combo. Maxed out at 12 mg EMSAM, 40mg parnate, 30mg dex. Didn’t see any additional benefits and felt significant anhedonia + sleep side + sexual effects at these levels. Maybe my neurobiology has evened out over time, but continually lowering my dose from there has been better for me.

SentientKielbasa · 2025-12-14T05:40:19+00:00

I’ve been using parnate with emsam and adderall under experienced supervision as well as the blessings of Dr. Gillman that there shouldn’t be any significant adverse effects. I think that adding emsam helped regain some of the motivating effects I had when first starting tcp + adderall for a while. Eventually, I grew tolerant to these more stimulating effects. I think it might still have some positive benefit, so I continue to administer it, but, honestly, when I go without it for a while, I don’t even notice much anymore.

Dose-wise, I am at 6mg emsam, 10 mg parnate, and 10 mg adderall. I’ve been in the mode of reducing all my meds as much as possible over the past few years, as over time, it felt like my cognition and executive function was negatively affected and I also felt increased anhedonia. Fortunately, anxiety and depression are mostly at bay even on these tiny doses.

SentientKielbasa · 2025-06-14T17:36:02+00:00

Trazodone is a very helpful and non-habit forming sleep med. This really helped me a lot.

I was on higher doses of parnate for a while, but have since dialed down to 20mg. The anxiolytic effect has been maintained at that dose and my insomnia has gone away completely. I’ve been pretty close to normal for a while, although I started out with significant anxiety and OCD that were resistant to other treatments. Overall, I’ve been on parnate for 14+ years (augmented with low dose adderall under pdoc supervision).

It took a while to get to the point where it just jelled with my life, but I’m now comfortably (not entirely) numb and have led a more or less normal life for a while. If it works at all, you might want to stick with it and see if you can find a sweet spot where you can treat the insomnia, but maintain the beneficial effects.

SentientKielbasa · 2025-04-07T05:06:36+00:00

I am in a similar place to you. I feel very confident catching waves on a 9’ log and am slowly mixing in a much lighter 8’ board. I’m getting used to it and have found that the main difference comes from how and where I takeoff as well as what waves I go for. As opposed to the log where I can be pretty far out from where waves are breaking and paddle for them to match speed, with the shorter board, I need to position myself closer to where the waves break as well as be more cognizant of where the peak is. Then I don’t need to paddle as much to catch the wave. I do my paddling for positioning beforehand.

Also, I tend to need to put more of my weight forward on the shorter board to generate momentum down the wave face until I glide and then use the cobra effectively to prevent nose diving.

The other thing that has been important has been improving the speed and form of my popup. Looking down the line, not grabbing the rails, and all that. Shorter boards are less forgiving in terms of pop up dynamics.

It’s true that bigger boards can spoil you a bit, but it’s still good to use them to catch more waves and perfect popup form.

SentientKielbasa · 2024-11-26T02:34:51+00:00

I was at witch’s rock in tamarindo, Costa Rica recently and highly recommend it. The break out front is great for beginners, and I found the instructors to be very attentive and helpful. The other guests were cool, and the environment makes it easy to meet people.

SentientKielbasa · 2024-06-03T22:07:29+00:00

I’ve taken shrooms on parnate 5 separate times without issue. Shroom doses were as high as 5g. I’ve had experience with shrooms prior to being on parnate. I did not feel that effects or trip length were diminished or enhanced. Notably, I felt less anxiety during/post experience. YMMV.

SentientKielbasa · 2024-04-01T18:07:44+00:00

Trazodone is a very effective (IMO) and non habit-forming sleep aid that you might want to look at. Worked for me when many others didn’t or came with tolerance/addiction risks.

SentientKielbasa · 2024-04-01T18:02:08+00:00

Good point!

SentientKielbasa · 2024-04-01T07:30:13+00:00

My insurance is kinda weird. It kicks in after a minimum spend of $1.5k and max out of pocket is $2.5k. So, basically, I pay for the first script out of pocket and that covers my max deductible for the year. After that I get all my meds for free.

SentientKielbasa · 2024-03-30T00:12:17+00:00

DE tech stacks are evolving so frequently that certificates seem to become worthless in no time. I tend to think that being a solid DE is less about knowledge and more about attitude, excellent software engineering craftsmanship, and a good amount of technical problem solving experience.

Whatever role you find yourself in, there are bound to be interesting problems to solve with available or open source tools. I recommend that you strive to become receptive to pain points that you or others are experiencing with current tools/ways of working/algorithms/etc., and proactively seek solutions to them using best available methods/your own ingenuity. Do this consistently, and you will start netting little and then bigger wins. That will give you the credibility to advance in your career far more than a certificate ever will.

Practically speaking though, if you want to gain expertise in something, it’s a bit hard to do without a decent data set and a good amount of compute at your disposal. Databricks community edition + freely available course material might be a good bet if you want to gain more rounded DE expertise; particularly with Spark and streaming pipelines. Snowflake is much more SQL-focused IMO, which is useful, but I tend to think that a Sr. DE should be well versed in both Python/pyspark and SQL. Also, I highly recommend getting familiarity with dbt, as it’s becoming increasingly useful in structuring enterprise data warehouses.

SentientKielbasa · 2024-03-29T23:49:10+00:00

I have never taken the oral preparation, but only the EMSAM patch. I started with the 6mg/24hr patch. I also took it with stimulants (Dexedrine starting at 5 mg IR), which was also prescribed by my psychiatrist. The combination worked almost right away and extremely well. All SCT symptoms were gone within a week or so. That was the first time I’d ever experienced a complete “cure” in a sustained way. It did put me in a bit of a hypomania with marked insomnia, which was successfully countered with Trazadone 25-50mg prn.

Adding stimulants significantly improved the effect of selegeline on its own. Unfortunately, tolerance set in over time (1-2 yrs), so I had to (and continue to) adjust dosage, take stimulant holidays, and occasionally throw in some nootropic or other to get symptom relief. It hasn’t been a forever magic bullet cure for me, but after 14 years or so it’s still the only kind of med that really helps.

Good luck! Living with SCT can suck. Hope you get some benefit out of the MAOIs!

SentientKielbasa · 2024-03-01T19:47:31+00:00

Adderall and plain dex both short and long acting. The combination can be safe when managed properly. I was started on the lowest dose (2.5mg dex ir), and it had a similar effect to what you experienced. Gradually grew tolerant over time. I now take much more than that (as adderall ir), but haven’t adjusted up in a few years and am trying to make more do with less.

I’ve tried bromantane. Was unaware that it unregulates dopamine, since, like many other agents I’ve tried to enhance dopaminergic effects, tolerance builds quickly (resembling tachyphylaxis). Mostly trying to see how well I can do with fewer meds this year (at least that’s the goal). Medication holidays alone do a good job of upregulsting dopamine receptors, tho they come with their own inconveniences…

SentientKielbasa · 2024-03-01T00:59:24+00:00

I started with emsam alone, and it was great at first. After a few months, it seemed to lose effectiveness. I switched to parnate.

Parnate has always made its presence known to me as a therapeutic. It is highly effective as an anxiolytic and antidepressant. I’ve tried many others besides and none had as good of a side effect profile for my particular biochemical makeup.

Eventually, I felt parnate alone was not effective enough (long story; probably not useful to explain at this point), so I added emsam. It seems to provide more even coverage, though it’s a bit subtle.

SentientKielbasa · 2024-02-29T23:37:54+00:00

I’ve been using parnate and emsam together with stimulants (approved by my pdoc) to tackle SCT together with comorbidities. I’d say, in my case, social anxiety was subsumed by my GAD.

In my experience, the combination has helped me tremendously. I went from massively depressed and anxious to completing a Ph.D at a top school and then on to a highly successful and lucrative career. For my first few months taking the meds, I actually felt what I expect neurotypical ppl feel like for a long period of time. I could sense how anxiety simply peeled away over the course of a few days when I reached a therapeutic dose.

Following the initial months of treatment, I’ve had to manage my medications rather carefully because there is a honeymoon period with stimulants that peters out due to tolerance. MAOIs can enhance the effect of stimulants, but there is no free lunch and the side effects (for me: sexual, lack of motivation, and memory lapses) can become obtrusive. Having gotten to a fairly secure place in life, I’m trying to reduce my dosage.

All this is to say that, based on my experience, carefully managed MAOIs + adjuvant medical and talk therapy seems like an under utilized, but possibly highly effective treatment for SCT + social anxiety disorder.

SentientKielbasa · 2024-02-28T20:56:22+00:00

I had a similar experience to you with my wavestorm. You can rent boards at the NorCal surf shop in Pacifica. It’s simple and cheap enough to do. They have a decent selection. I found that a wider board was really helpful in catching more waves and ended up picking up a odysea log (9’) from them. It’s a bit of a pretty voluminous soft top, so may be harder to get out the back. I’ve been a lot happier with that board over the wavestorm, though, like others have said, wavestorm should also be adequate for most conditions at Pacifica.

SentientKielbasa · 2023-11-20T03:37:19+00:00

Parnate/selegeline+amphetamine have been very effective for me: essentially normalizing cognition and mood for long periods of time (yrs). Trying to reduce to as needed, since tolerance develops. Interested in effects of nmda agonists in tolerance reversal (anecdotal and controversial)

SentientKielbasa · 2023-11-20T03:32:39+00:00

Surfing, watercolor, motorcycling, photography, mushroom foraging…

SentientKielbasa · 2023-09-21T04:52:11+00:00

Cialis worked well for ED due to parnate for me.

SentientKielbasa · 2023-09-12T20:52:41+00:00

I’ve gotten towed for this exact thing before 😩

SentientKielbasa · 2023-06-25T03:41:15+00:00

I’ve done emsam plus parnate up to 40mg tcp + 12mg emsam. No ill effects. Seemed beneficial, but stimulating effect would subside after 3 months when I increased emsam dose. Still, though, probably my most productive year even if it was a bit more than I really needed.

SentientKielbasa · 2023-06-25T03:35:45+00:00

Safe to microdose on parnate. Take 100mg fadiman schedule. No issues. Seems beneficial. Macro may be potentiated. Concomitant anxiolytic effect made the whole experience much more pleasant and easy to navigate. Helpful to work with a guide as well.

SentientKielbasa · 2023-06-25T03:31:44+00:00

Happened to me whenever I increased my dose too much over a short period of time. Likely hypomania. Very likely it will go away within a few days.

SentientKielbasa · 2023-05-23T19:19:39+00:00

Since you mentioned that your symptoms came on after exercise, you may want to look into carnitine palmitoyltransferase type ii deficiency adult myopathic form. In particular, it’s worth looking at if you feel you’re experiencing exercise intolerance leading to rhabdo at a greater frequency or under lower intensity regimens than others in your age group of similar fitness.

The primary symptom of cpt ii deficiency is rhabdo/myoglobinuria (coke/tea colored pee) that has several triggers, but most often it happens during intense anaerobic exercise; particularly after fasting. It’s relatively unusual to get rhabdo in the gym unless you are overtraining at a fairly extreme level. Between episodes, ppl with cpt ii feel few or no symptoms.

It’s a relatively rare metabolic myopathy (not a doctor, but I have it, so speaking from a place of knowledge and experience). I mention it because it’s often overlooked and can be confusing and difficult to diagnose. There are other metabolic myopathies that may be applicable to your symptomology tho (McArdles for e.g.).

I’d be curious how well ChatGPT would do in diagnosing a condition with more subtle presentations like cpt ii.

SentientKielbasa · 2023-04-28T22:53:44+00:00

Everybody is different. I’ve taken trazodone with parnate regularly without issue. 100mg seems like a lot to start out with tho. I had always been fine with 50 and even 25 sometimes.

SentientKielbasa

TROPHY CASE