Posted by Sad Panda on March 16, 2004, at 7:55:16
In reply to Re: Anyone else on 2 SSRI's?, posted by gabbix2 on March 15, 2004, at 20:06:52
> Not quite true. Though Remeron is not labelled an SSRI does not mean it doesn't affect Serotonin.
> It does, and can when mixed with an SSRI's cause Serotonin Syndrome.
>
> Here's a link
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11675850&dopt=Abstract"Serotonin syndrome induced by fluvoxamine and mirtazapine.
Demers JC, Malone M.
Albany College of Pharmacy, NY, USA.
OBJECTIVE: To document a case of serotonin syndrome associated with the combined use of fluvoxamine and mirtazapine, and to discuss the pharmacodynamic and pharmacokinetic interactions that were the likely causes of this potentially serious adverse drug reaction (ADR). CASE SUMMARY: A 26-year-old white woman with a 12-year history of anorexia nervosa was being treated with fluvoxamine. After mirtazapine was added to her therapy, she developed tremors,restlessness, twitching, flushing, diaphoresis, and nausea,symptoms that are consistent with serotonin syndrome. DISCUSSION: The possible causes of this ADR are discussed, including the effects of fluvoxamine and mirtazapine alone, the possible pharmacodynamic and pharmacokinetic interactions of these two drugs, and the patients underlying anorexia nervosa. CONCLUSIONS: An increasing number of drugs that affect serotonin are available and are indicated for various disorders. Since there is a significant likelihood of these agents being prescribed concomitantly, clinicians must be aware of possible interactions that could lead to serotonin syndrome.
Publication Types:
Case ReportsPMID: 11675850 [PubMed - indexed for MEDLINE]"
Hi Gabbix2,I would guess that the poor ladies anorexia was a major factor in this case. Remeron causing Serotonin Syndrome would be incredibly rare. Remeron doesn't block the reuptake of Serotonin, so it isn't an SSRI, it blocks Serotonin from 5-HT2A, 5-HT2C & 5-HT3 receptors which leaves a little more Serotonin for the 5-HT1 group, which is believed to have an antidepressant effect.
Cheers,
Panda.
poster:Sad Panda
thread:324479
URL: http://www.dr-bob.org/babble/20040313/msgs/324874.html