Posted by Iago Camboa on August 6, 2002, at 2:47:35
In reply to Nardil + imipramine = serotonin syndrome, posted by SLS on August 4, 2002, at 13:25:26
Hi Scott,
Ouch! I'm sure it was no 'sweet pear' that one! Are you defying the devil? 300mg imipramine and 60mg phenelzine even carefully titrated (let alone the Lamictal) may be enough to knock out a bison! I think you are lucky to be alive...
How have you proceeded? Did you lay down on bed and waited it to end? Had your doc provided some pill for just in case? Have you any stubborn treatment-resistent depression? Have you tried Nardil + Dexedrine + Lamictal? Or clomipramine/Anafranil + Dexedrine + Lamictal?I wish you the very best of luck.
Iago>
> Nardil + imipramine = serotonin syndrome
>
> I had been adding Nardil to a combination of Lamictal 300mg and imipramine 300mg. I never had any problem with a similar combination using high dosages of Parnate. My muscles became rigid, especially around the neck. I had difficulty walking and was very weak and unsteady on my feet. My leg muscles were rigid. I experienced tremors throughout my whole body and sweated profusely. I became dysphoric and found it difficult to focus on what was going on around me. I thought these things were due to the NE reuptake inhibition and anticholinergic effects of imipramine. After some consideration, my doctor decided that it was the onset of serotonin syndrome. I was OK until the dosage of Nardil was raised from 45mg to 60mg. I had been titrating very slowly, having reached 60mg after at least 8 weeks.
>
> I guess I have been underestimating the potency of tertiary tricyclic TCAs to inhibit the reuptake of serotonin. The only problems I ever had using Nardil with desipramine, an extremely selective NE reuptake inhibitor, was low blood pressure and urinary hesitancy.
>
> I guess the lesson is that a healthy respect for the serotonergic properties of TCAs is warranted when combining them with MAOIs, particularly Nardil.
>
>
> - Scott
>
poster:Iago Camboa
thread:115170
URL: http://www.dr-bob.org/babble/20020731/msgs/115374.html