Posted by mattz on March 5, 2004, at 23:09:55
Hi, first post so go gentle on me. ;)
I'm confused about what I have read about serotonin syndrome. First of all, I should make it clear that I do know that using SSRIs and MAOIs is considered a big no no, with documented cases of severe reactions, some of which have lead to fatal consequences. I also know that some of the TCAs and other more stimulating drugs can be relatively safely used with the MAOIs. However, what I would like to know is if the likelihood of getting serotonin syndrome for an SSRI/MAOI or another strongly serotoninergic combination of drugs, is directly related to how depressed you are in the first place - i.e. natural levels of serotonin deficiency?
What are the initial symptoms of serotonin syndrome? Presumably there is some degree of euphoria before the more severe side effects set in? In other words, if you start using very small tapered dosages of an MAOI to add to an SSRI, might it be possible to predict an excess of serotonin, before anything too dramatic happens?
Finally, is there ever a case for using an SSRI (or Clomipramine for that matter) in combination with an MAOI? - and by that, I mean a non-reversible MAOI. What about in the case of someone with severe treatment resistant depression, who has tried all forms of antidepressants and and other related drug combinations? If so, then should it be used before or after ECT?
I should also add that I'm not going to use the information received to my question above as an aid to self medicating in any way.
Thanks a lot,
Mattz
poster:mattz
thread:320939
URL: http://www.dr-bob.org/babble/20040304/msgs/320939.html