Posted by SLS on July 24, 2004, at 10:42:02
In reply to Switching to MAOI??? Please advise.., posted by RetiredYoung on July 24, 2004, at 10:02:37
Hi.
Waiting 14 days after taking your last dose of Lexapro before starting an MAOI is the only way to guarantee that you won't experience a serious reaction. You might hear stories of people making the switch between drugs successfully without waiting, but the risk does exist. The most immediate risk is of a reaction known as serotonin syndrome. It can occur when an MAOI is combined with any drug that blocks the reuptake of serotonin (5-HT), such as Lexapro. It can be fatal. The reaction can include severe mental confusion and incoherency, coma, hypertension, hyperpyrexia, tachycardia, myoclonus, hyperreflexia, muscle rigidity, and a bunch of other nasty things. Believe it or not, the waiting period recommended for Prozac is 5 weeks. I really don't know how far it makes sense to push things. I wouldn't go any sooner than one week, though.
Parnate might be a good choice for you. It has amphetamine-like properties, and is usually more tolerable with respect to side effects than is Nardil. In addition, it is easier to work with if you want to add things like tricyclic antidepressants. I have combined Parnate + desipramine + amphetamine + thyroxine. There is also the opportunity to use a high-dosage Parnate strategy that is sometimes effective in difficult cases that involves dosages above 100mg.
Good luck.
- Scott
poster:SLS
thread:369906
URL: http://www.dr-bob.org/babble/20040724/msgs/369918.html