Posted by Sad Panda on August 3, 2004, at 1:22:42
In reply to Re: Norepinephrine vs. Dopamine » Sad Panda, posted by sb417 on August 3, 2004, at 0:43:00
> It is not necessarily true that you can add desipramine to any antidepressant. You shouldn't add it to an MAOI
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>You can actually add some TCA's to MAOI's. If the TCA isn't a serotonin reuptake inhibitor then it will actually improve the safety of an MAOI. Desipramine, Nortriptyline, Doxepin & Trimipramine can all be added to an MAOI depending on if you need stimulating or sedating. Clomipramine & Imipramine are dangerous due to risk of serotonin syndrome & I would not risk Amitriptyline either although you can find it combined with an MAOI in a pubmed search.
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> and if you are particularly sensitive to medication combinations and/or if you have a genetic polymorphism for some of the cytochrome P450 enzymes, especially the 2D6 enzyme, you probably could not add a tricyclic to any antidepressant. Some people have no problem with polypharmacy; others are extremely sensitive to drug combos and can get very sick or die from indiscriminate mixing of medications. It is best that any attempts to mix medications are done under a doctor's supervision.
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>That's true, but I wasn't suggesting starting desipramine at 100mg either. Starting at 25mg would be fine.
Cheers,
Panda.
poster:Sad Panda
thread:373267
URL: http://www.dr-bob.org/babble/20040730/msgs/373470.html