Posted by SLS on April 24, 2004, at 7:31:41
In reply to anyone ever combine REMERON and MAOI????, posted by ace on April 24, 2004, at 0:59:52
This might be a stretch, but...
I 1992, I was being treated with investigational drugs at the NIH. I was first exposed to idazoxan, a potent NE alpha-2 antagonist similar to Remeron and the antithesis of clonidine, for several months. I was then abruptly switched to clorgyline, an irreversible MAOI-A. This action resulted in my experiencing a hypotensive crisis. My blood pressure became so low, that I entered a state of delirium that lasted for days. I don't recall exactly what my blood pressure was, but I believe they were talking about it being somewhere around 30-35 Hg. I will presume for the sake of argument that this was the result of the upregulation of presynaptic NE alpha-2 autoreceptors induced by idazoxan and the subsequent application of the MAOI. I guess if someone were to extrapolate this rebound effect inside out, perhaps the extreme reverse would yield a hypertensive effect. I don't know enough about the pharmacology behind the hypotensive effects of MAOIs to be able to comment on some of the possible mechanisms involved with this interaction. However, it should be noted that the sudden withdrawal of clonidine, a NE alpha-2 agonist in the presence of a beta-blocker yields a serious hypertensive reaction. This would be a sort of inverse analogue to what I experienced with the withdrawal of idazoxan in the presence of a pro-adrenergic drug (MAOI).
Be careful. You better do your homework on this one. It might not be a bad idea to have some propranalol on hand. I don't know if clonidine would be of value in an emergency.
- Scott
poster:SLS
thread:339422
URL: http://www.dr-bob.org/babble/20040423/msgs/339457.html