Posted by ed_uk on December 9, 2004, at 9:25:39
Hello!
From the article that djmmm posted......
'The combination of inhibition of MAO with inhibition of reuptake may result in a flood of 5-HT and NE into the synapse, exceeding its capacity for enzymatic catabolism. The only effective route of catabolism for excess 5-HT is through MAO; catecholamines, on the other hand, can be catabolized also by catechol-o-methyl transferase (COMT). Thus, when combined with inhibition of MAO, the blockade of 5-HT reuptake may have greater potential for CNS toxicity than the blockade of catecholamine reuptake.' ....Hence the potential severity of the SS caused by an MAOI + a SRI.
Combining an MAOI with a selective inhibitor of norepinephrine reuptake seems to have been relatively safe (in the limited number of people who have taken this combination). Serious adverse effects have occured only rarely with this combination. ..........But what would be the effect of combining an MAOI with a NE reuptake inhibitor and a COMT inhibitor???? The norepinephrine syndrome?! Tell me what you think.
Regards,
Ed.
PS. COMT inhibitors include entacapone and tolcapone.PPS. Selective norepinephrine reuptake inhibitors include desipramine and reboxetine.
poster:ed_uk
thread:426670
URL: http://www.dr-bob.org/babble/20041206/msgs/426670.html