Posted by SLS on November 8, 2004, at 23:50:50
In reply to Re: The Forbidden Combination, posted by TheOutsider on November 8, 2004, at 15:44:12
> Regarding the combinations of MAO and SSRI I have some experience, I also know it can be done.
> I think combining is often done when the patient is in hospital so they can be monitored.
>
> I personaly combined Moclobemide with low dose Citalopram on a one of occasion, it made me feel ok but I did have the feeling that if I'd gone higher it might not have been good.
> I also combined Moclobemide with generic Fluoxetine which caused a panic attack!
>
> I think that Clomipramine and an MAO might go well together, Clomipramine is a Serotonin antagonist as well as a re-uptake inhibitor, which helps reduce the chance of serotonin syndrome apparently.
>
> I don't mean to be jugmental but are you sure you want to try this combination? How about combining a stimulent like Dexedrine with Nardil, I personaly think this would be safer, I know others will disagree!
While the reversible MAOI moclobemide and serotonin reuptake inhibitors have been combined successfully, I don't think the same can be said of the irreversible MAOIs like Parnate, Nardil, and Marplan. It is my impression from the literature and from personal experience that the chances of developing serotonin syndrome from combining the irreversibles is greater than 50%. If you are still inclined to try such combinations, be sure to learn the symptoms of serotonin syndrome thoroughly so as to catch it at the very beginning of its induction. Still, I wouldn't recommend that anyone try it.In order of severity, I have experienced serotonin syndrome from:
Parnate + Effexor
Nardil + imipramine
Nardil + nortriptyline
clorgyline + trazodoneI would avoid clomipramine.
In my experience, combining MAOIs with amphetamine, methylphenidate, or desipramine is safe.
- Scott
poster:SLS
thread:413243
URL: http://www.dr-bob.org/babble/20041108/msgs/413583.html