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Re: MAOIs and safety » kregpark@yahoo.com

Posted by SLS on September 1, 2001, at 7:33:29

In reply to Re: MAOIs and safety » IanSFO, posted by kregpark@yahoo.com on September 1, 2001, at 5:03:18

Hi KregPark.


> I'll throw in my 2 cents also.
>
> About the dangers of MAOI interactions:
>
> My personal opinion is that serotonin syndrome is the main risk for most MAOI users

I would have to agree with you. While taking Parnate (120mg), desperation led me to wanting to see what would happen if I were to add a serotonin reuptake inhibitor. I chose Effexor because it had the shortest half-life. Should anything untoward happen, I figured it was better to use a drug that woul clear as soon as possible. I tried to be smart. I ultimately failed. I decided bite off the smallest piece of a 75mg tablet (original immediate-release preparation) to use as a challenge. It couldn't have been more than 15mg. Somewhere in between 15 and 30 minutes, I was totally incoherent and babbling total nonsense. Lying on the bed, I could not sit up. I don't remember if there was any rigidity involved. I don't think so. My parents were there. Somehow I managed to collect myself enough to have them take my temperature. It might have been a degree or two above my norm. I didn't do a very good job reassuring them that everything would be all right I told them that I just needed to reboot my system. I was pretty much OK within an hour. Of all the aggressive drug combinations my doctor was willing to consider, it was only MAOIs + SSRIs that he firmly rejected.

> , but I also think the risk of serotonin syndrome goes for anyone on a serotonergic (almost every antidepressant sold!).
> Basically any two antidepressants should be used together with caution (even single drug regimens like Paxil and Effexor have led to serotononin syndrome deaths).

You'll even find reports of serotonin syndrome developing upon the addition of lithium to an SSRI.

> To Nardil, I have cautiously added (incrementally increasing dose) of stimulants or stimulant like meds such as Ritalin, Dexedrine, amantadine, Wellbutrin, amineptine, tianeptine, PROVIGIL, yohimbine, caffeine pills (part of my regimen actually);

Oh my. You've been busy.

I hope you don't mind if I ask but a few questions.

What has worked best for you?

How did you react upon adding each of Provigil, amantadine, and yohimbine?

> also Serzone (this one can make Nardil much like Parnate!!!),

This is one combination that I have been very interested to try. Last year, I was about to add Serzone to Parnate + desipramine + Lamictal, but grew shy when one of our posters here described what might have been some sort of dystonic reaction upon adding it to Nardil. Can you be specific on how adding Serzone changed your experience such that Nardil felt like Parnate?

> Relative safety is good as you'll see on Medline or by calling manufacturuers.

> Driving to your docs office is likely factors of 10 times more dangerous than all your years of MAOI!!!

I agree.

Thanks much in advance for any input you can provide me.


Sincerely,
Scott

 

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