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Re: MAOI + TCA- info please now!

Posted by SLS on April 10, 2004, at 15:29:31

In reply to Re: MAOI + TCA- info please now!, posted by djmmm on April 10, 2004, at 11:44:21

Hi.

> Bupropion, Trazodone, Remeron* and all TCA's (other than clomipramine) can be safely combined with MAOIs

I developed what my doctor identified as a serotonin syndrome type reaction when combining Nardil 60mg + imipramine 300mg. I'm not sure whether it was or not. However, I did experience severe hypotension and dystonia among other things. I never experienced anything similar when combining Nardil + desipramine, though. For me, no such reaction occurs when the dosage of Nardil is kept at 45mg or lower, even when combined with amitriptyline.

Parnate 120mg + desipramine 300mg was OK.

Everyone is so different. I would recommend caution when adding a TCA. Supposedly, it is safer to add an MAOI to an ongoing treatment of TCA or start them together than it is to add a TCA to a MAOI. I've done it both ways without a problem. MAOI with Wellbutrin seems safe. I've done that. There have been reports of adverse events when combining MAOI with Remeron. There is some debate whether or not these incidences were serotonin syndrome. I would guess that the NE alpha 2 receptor antagonism produced by Remeron might yield sympathetic overload and dysautonomia. Again, everyone is so different. The potential of MAOIs to produce serious adverse reactions when coadministered with other drugs should be respected. I don't know what to think when it comes to Remeron. I do like the idea of using TCAs, but with Nardil, I think it might be best to use desipramine.


- Scott

 

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