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Re: Change MAOI same day???????sls

Posted by SLS on July 29, 2003, at 6:05:36

In reply to Re: Change MAOI same day???????sls, posted by ross co on July 28, 2003, at 21:41:29

Hi Ross.

> i went from lexapro to nardil in one day. not very smart

Maybe it is smart, I don't know. The thing that is dangerous is to switch from an MAOI to another drug too rapidly. I think it takes about 10 days for MAO activity to recover.

> but SS is very very rare.

I don't think serotonin syndrome is all that rare when someone mixes MAOIs and serotonin reuptake inhibitors. I got a heck of a SS reaction from adding about 15mg of Effexor on top of an ongoing trial of Parnate 120mg. Symptoms included a delerium that had me babbling nonsense for over a half-hour. I also experienced SS symptoms when trying to combine imipramine with Nardil. This included muscle stiffness and severe hypotension.

The other thing about switching from Nardil to Parnate is that there may be risks other than serotonin syndrome. I think a hypertensive reaction should be a concern, especially in light of the frequency with which initiating Parnate therapy in the absence of another MAOI can raise blood pressure.

> it takes an mao 2 weeks at least to bypass the gut.

I didn't know that was the obstacle. Thanks for the info.

I know that people have successfully switched between MAOIs and other drugs with little or no waiting period in between. I just don't know enough to encourage someone else to try it.


- Scott

 

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