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Re: MAOI/Reboxetine Combo For Cheese Effect

Posted by MH on August 12, 2000, at 8:16:39

In reply to Re: MAOI/Reboxetine Combo For , posted by Adam on September 13, 1999, at 18:41:16

> I've seen only one reference to support this idea:
>
> Reboxetine prevents the tranylcypromine-induced
> increase in tyramine levels in rat heart
> by
> Dostert P, Castelli MG, Cicioni P, Strolin Benedetti M
> Farmitalia Carlo Erba,
> Research and Development,
> Erbamont Group, Milan, Italy.
> J Neural Transm Suppl 1994; 41:149-53
>
> ABSTRACT
>
> This study aimed to examine whether the increase in heart radioactivity levels after intravenous
> injection of 14C-tyramine to rats pretreated with the irreversible MAO inhibitor tranylcypromine could be
> antagonized by reboxetine, a potent and selective noradrenaline uptake blocker. Reboxetine was found
> totally to abolish the effect of tranylcypromine. Heart radioactivity levels after reboxetine and
> tranylcypromine were very similar to those found when tyramine was injected after reboxetine only.
> These results suggest that reboxetine might be advantageously combined with tranylcypromine, or any
> MAO inhibitor, in depressed patients unresponsive of either treatment given alone.
>
> Have you seen others?
>
> Anyway, I personally have some difficulties with the leap from the authors' findings to abrogation of the "cheese effect". I'm not sure their
> experimental approach has much clinical relevance. Plus, as Elizabeth pointed out somewhere, there's already some precendent for this idea in
> the use of certain tricyclics (which, being fairly potent noradrenergics/NE-reuptake inhibitors might do the same thing), but nobody seems to be
> using this approach in practice...I assume because it doesn't work.
>
> My guess is that since certain TCA/MAOI combos are used in treatment, adding rebox. to an MAOI ought to be safe. Umm, JohnB, how does your doc
> plan on testing the idea? I know the cheese effect is rarely lethal, but it can be pretty uncomfortable, from what I understand, and is potentially
> dangerous. I can imagine such an experiment might raise some serious eyebrows in certain circles. If somebody gave a Rehsus monkey rebox+parnate+a
> bunch of tyramine orally and it's was OK, I might feel bit more confident this is a good idea.
>
>
> > Read several suggestions in literature recently that the NARI reboxetine may eliminate/modify the need for dietary restrictions if administered with the classic MAO inhibitors. What's the latest scientific information on this combination. Has anyone out there tried this combination with success?
> > It seems to me that, if true, this MAOI/NARI cocktail might prove to be one of the most potent anti-depressant treatments ever.


Anyone ever heard of reversible MAOIs? (RIMAs): Aurorix (Moclobemide)/Mannerix or Brofaromine - no diet restrictions and very good I hear...


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