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Re: Maprotiline + MAOI? » KaraS

Posted by SLS on December 20, 2004, at 7:16:18

In reply to Maprotiline + MAOI?, posted by KaraS on December 19, 2004, at 19:29:41

Hi Kara.

> Can maprotiline be taken with an MAOI?

I don't know for sure, but I would guess that you can. I'm sure you are aware that it is a relatively selective inhibitor of NE reuptake relative to 5-HT. However, I would be more inclined to go with nortriptyline or trimipramine or even desipramine if you are intent on using a TCA for anxiety and are looking for compatability with an MAOI.

What other treatments have you considered for anxiety? Do you have these medications on hand? Zyprexa would be effective I bet, and would probably add some AD effects. It is also compatable with MAOI.

My guess is that the contraindications for hyperthyroid patients of TCAs and maprotiline involves NE reuptake inhibition, anticholinergic effects, and the consequences these actions have on an already accelerated heart-rate, palpitations, and arrythmias. Remember, however, that thyroid hormone is often given in supratherapeutic dosages to augment TCAs. I wouldn't worry too much about it.

If you are going to choose Parnate, it would be a good idea to monitor for a hypertensive reaction upon initiating treatment. This sometimes occurs as a startup effect, and is not dosage dependant. Symptoms of a reaction would include:

• occipital headache which may radiate frontally
• palpitation
• neck stiffness or soreness
• nausea or vomiting
• sweating (sometimes with fever and sometimes with cold, clammy skin)
• photophobia
• either tachycardia or bradycardia
• constricting chest pain
• dilated pupils


- Scott

 

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URL: http://www.dr-bob.org/babble/20041217/msgs/431970.html