Posted by Jedi on August 2, 2005, at 3:34:31
In reply to TCA_to_MAOI?, posted by EERRIICC on July 30, 2005, at 13:48:47
> Can a TCA be added onto an MAOI?
The combined use of TCAs and MAOI's, though officially contraindicated, can be carefully administered by an experienced MD. The meds should be started simultaneously in low doses or the MAOI added to an established dosage of TCA. Serious consequences have resulted when adding a TCA to an established dosage of MAOI! I have used phenelzine at 60mg combined with 100mg of nortriptyline with no unusual side effects.
There are quite a few PUBMED abstracts that refer to the combined use of these two medications. Here's one:
J Clin Psychiatry. 1984 Jul;45(7 Pt 2):67-9.
The combined use of MAOIs and tricyclics.
White K, Simpson G.
Combined MAOI-tricyclic treatment remains a plausible approach to depressions refractory to single drugs. Adherence to published guidelines should minimize special risks of the combined treatment. However, such risks do exist, and should be borne in mind. Most severe reactions - characterized by hyperthermia, delirium, convulsions, and sometimes fatal outcome - have occurred after a tricyclic was added to established MAOI treatment. Combined treatment may be associated with a lower risk of hypertensive crisis than treatment with MAOI alone. There are no data from double-blind, control-group studies to demonstrate an advantage for the MAOI-tricyclic combination in refractory depression. However, almost no such data exist to establish the advantage of any other treatment in this clinical situation. Clinical experience provides the primary basis for continued consideration of this approach when usual treatments have failed.
Publication Types:
Case Reports
Clinical TrialPMID: 6376486 [PubMed - indexed for MEDLINE]
poster:Jedi
thread:535657
URL: http://www.dr-bob.org/babble/20050728/msgs/536619.html