Posted by SLS on May 12, 2002, at 11:34:01
In reply to Just read about safety of that combination today, posted by 3 Beer Effect on May 11, 2002, at 23:06:45
> Hello,
>
> I was looking through the PUBmed research on desipramine today & I ran across some articles that said the combination of desipramine & celexa was safe & well tolerated. See the Canadian website mentalhealth.com, click on desipramine, & then click on research, & it will give you a list of research topics about desipramine- click on the topic you want to know about & it will pull up all of the relevant PUBmed research article on it.
>
> In other articles, some SSRIs, Prozac & one other one newer AD- i think Effexor (not Celexa) had pharmacodynamic & TCA blood level interactions with desipramine/Norpramin, so anyone on a combination of an SSRI and a tricyclic should be very careful (wary) & read up on all the research they can to avoid a potentially hazardous combination or the possibly fatal serotonin syndrome.
>
> Also, I have heard from several people & even read in some research articles that the name brand of desipramine, Norpramin is better tolerated (less side effects & toxicicity) & works better than generic desipramine.
>
> 3 Beers...................Good catch, 3 Beers.
I forgot about that. Both drugs are metabolized by cytochrome P450 2D6. Celexa probably increases the level of desipramine by 50% or so. Please check my math. I guess one should reduce the target dosage of desipramine from:
without Celexa > with Celexa
75 > 50
100 > 75
150 > 100
300 > 200I once combined Paxil with desipramine. Paxil increased the level of desipramine by at least 100% - probably more. Paxil is much more potent than Celexa in this respect (P450 2D6 inhibitor). One can always get blood-tests to monitor desipramine.
A chart I have floating around on my computer indicates that Effexor levels are moderately increased by desipramine and nortriptyline rather than the reverse. I really didn't notice anything untoward when I was taking Effexor 300mg + nortriptyline 100mg.
- Scott
poster:SLS
thread:106051
URL: http://www.dr-bob.org/babble/20020510/msgs/106103.html