Posted by Larry Hoover on March 14, 2009, at 20:13:31
In reply to I know you guys are going to kill me, but...., posted by Cseagraves on March 14, 2009, at 19:31:05
You have to wait. Do not take the Marplan tomorrow. If you've only been on the Zoloft for three days, and you're starting at such a low dose of Marplan, you might get away with a week between the drugs, but I'd wait at least 10 days. The monograph calls for at least two weeks.
"Marplan should not be administered in combination with any SSRI. There have been reports of serious, sometimes fatal, reactions (including hyperthermia, rigidity, myoclonus, autonomic instability with possible rapid fluctuations of vital signs, and mental status changes that include extreme agitation and confusion progressing to delirium and coma) in patients receiving fluoxetine (Prozac®, Lilly) in combination with a monoamine oxidase inhibitor (MAOI), and in patients who have recently discontinued fluoxetine and are then started on a MAOI. Some cases presented with features resembling neuroleptic malignant syndrome. Fluoxetine and other SSRIs should therefore not be used in combination with Marplan, or within 14 days of discontinuing therapy with Marplan. As fluoxetine and its major metabolite have very long elimination half-lives, at least 5 weeks should be allowed after stopping fluoxetine before starting Marplan. At least 2 weeks should be allowed after stopping sertraline (Zoloft®, Pfizer) or paroxetine (Paxil®, SmithKline Beecham Pharmaceuticals) before starting Marplan. In addition, there should be an interval of least 10 days between discontinuation of Marplan and initiation or fluoxetine or other SSRIs."
Lar
poster:Larry Hoover
thread:885343
URL: http://www.dr-bob.org/babble/20090313/msgs/885363.html