Posted by undopaminergic on April 10, 2008, at 5:09:51
In reply to What Other AD meds can you take with Parnate?, posted by Cheryl-Lynn on April 9, 2008, at 19:28:20
It really depends on the dose of Parnate and on the dose of the other medication, and on various factors that vary between individuals - some are more sensitive and may experience serious reactions even to seemingly innocuous combinations, such as a SSRI with selegiline at doses generally regarded as selective for MAO-B (which has no role in serotonin metabolism).
To put it simply, there are two dangers: hypertensive crisis and the serotonin syndrome. The former is caused by substances that drastically elevate extracellular noradrenaline levels, and the latter is caused by serotonin-elevating compounds. Drugs that don't have those effects - directly or indirectly - should be safe, at least in theory.
Due to their noradrenaline-releasing effects, amphetamines taken during MAOI treatment may cause hypertensive crises, and some deaths (surprisingly few) have been reported. On the other hand, with proper caution the combination has been used safely.
All SSRIs and SNRIs are, obviously, potent serotonergic agents, and have high potential for toxicity when combined with MAOIs; deaths have been reported. Unfortunately, most commonly used antidepressants are in this category.
Some tricyclic antidepressants (TCAs) have serotonergic effects - more specifically clomipramine and imipramine (but not others), and combinations with MAOIs have been associated with fatalities.
Other TCAs, specific noradrenaline reuptake inhibitors, dopamine reuptake inhibitors, and combinations thereof seem to be safe (e.g. amitriptyline and bupropion have been tested safely with Parnate), although caution is still recommended.
Anticonvuslants and mood stabilisers should be safe in theory, and combinations of tranylcypromine with lithium have been tried.
Mirtazapine increases noradrenaline release, and although there seem to be no reports of interactions with MAOIs, there is theoretical potential for hypertensive reactions.
Tianeptine seems safe in theory and there are no reports of interactions, but no reports of successful combinations either.
poster:undopaminergic
thread:822468
URL: http://www.dr-bob.org/babble/20080330/msgs/822533.html