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Re: Why no DXM with a maoi? » medievil

Posted by Quintal on December 26, 2006, at 20:36:34

In reply to Re: Why no DXM with a maoi?, posted by medievil on December 26, 2006, at 3:52:14

Medievil, your'e being very complacent about combining contrindicated substances with MAOIs lately. Yes, some people have very rarely combined a variety of these subastances with MAOIs, but they almost certainly did so under close medical supervision - in hospital with vital signs being monitored every few minutes with resuccitation equipment on standby.

>there's a danger but i heared tricyclics are combined with maoi's so this should work too?
if done very slowly?

No, not at all. Some serotogenic tricyclics such as clomipramine are completely contraindicated with MAOIs. You could administer aged cheese very carefully and slowly yet still have a hypertensive crisis.

Why are you determined to experiment with such dangerous combinations when you don't yet know what your response will be to Parnate alone?
__________________________________________________
Drug-Drug Interactions

dextromethorphan and tranylcypromine (major Drug-Drug)
Description:
CONTRAINDICATED: Monoamine oxidase inhibitors (MAOIs) may potentiate the activity of serotonergic agents such as serotonin reuptake inhibitors, 5-HT1 receptor agonists, ergot alkaloids, buspirone, dextromethorphan, and most antidepressants. The result may be an increased risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5HT1A receptors and characterized by symptoms such as CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia. The mechanism is an additive pharmacodynamic effect resulting from MAOI inhibition of serotonin metabolism.
MANAGEMENT:
In general, serotonergic agents should not be used concurrently with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, procarbazine). At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with serotonergic agents. A washout period of 7 to 14 days minimum is recommended when switching from another antidepressant to an MAOI.
http://www.drugs.com/xq/cfm/pageID_1150/int_1/list_1/values_drugid%3Dd00207%26drugid%3Dd00884%26/OpText_Parnate/dr_%2Cdextromethorphan%2CParnate/qx/index.htm
__________________________________________________

There are other NMDA antagonists and similar drugs that affect the NMDA receptors like Lamictal that can be safely combined with MAOIs.

Q


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poster:Quintal thread:716420
URL: http://www.dr-bob.org/babble/20061224/msgs/716595.html