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Re: can Remeron + Luvox be combined safely? » Phillipa

Posted by yxibow on January 14, 2007, at 19:12:42

In reply to Re: can Remeron + Luvox be combined safely? » yxibow, posted by Phillipa on January 13, 2007, at 18:49:14

> Jay so you've improved so much in OCD that you no longer require luvox but depression is worse hence cymbalta. You think that med is better? And doesn't luvox increse the effects of valium and xanax and not ativan? Why would that be. Thanks Phillipa

Well... I have OCD for life as anyone does, but the classic presentation of hoarding, washing, etc, is basically gone; the garbage track thoughts when I get anxious are still there, they're hard to fight. You learn the tools of CBT and you apply them later.

Luvox did help me stop worrying 16 hours a day about my disorder; Cymbalta is not as effective at that but it was more clear to my psychiatrist that I was developing MDD, whether it was primary or secondary (depression about my 5+ year condition) was irrelevant so that was the switch.

Whether we later on in the future gently add something like lexapro is still on the table but have to avoid serotonin syndrome.


Correct.. Luvox is an Inhibitor at 3A4. Valium and Xanax are Substrates at CYP-3A4 and thus, the prescribed dose of Luvox will "inhibit" the time that it takes for Valium and Xanax to leave the body, thus increasing the level of Valium or Xanax in the body. The same goes for Versed (which is only a hospital pre-op sedative or conscious sedative for minor surgery) and Halcion (not used much for sleep because of past issues).


The laundry list also goes for inhibition of BuSpar, a variety of calcium channel blockers, Trazodone, Orap, methadone, clarithromycin and related antibiotics, some HIV protease inhibitors, OTC clorpheniramine (although I doubt the dose OTC would matter much).


A fairly good clinically relevant list of P450 interactions can be found at

http://medicine.iupui.edu/flockhart/clinlist.htm

Minor interactions at

http://medicine.iupui.edu/flockhart/table.htm

 

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