Posted by Caedmon on April 10, 2006, at 14:20:35
In reply to Re: Parnate is often augmented with Lithium, posted by linkadge on April 10, 2006, at 12:49:36
Hi Link,
I can understand the need for caution but my understanding is that Li acts somewhat paradoxically on 5HT. I also believe that the combination is not uncommonly used.
I just find it an interesting circumstance that your pharmacist freaked out about it like that, and that you had such a negative reaction to the combination. I haven't heard of such a thing before.
Yes, I should think that all augmentation strategies for MAOIs should be done cautiously (450mg Li is probably a bit much in my view).
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Am J Psychiatry. 1988 Feb;145(2):249-50.
The combination of lithium carbonate and an MAOI in refractory depressions.Fein S, Paz V, Rao N, LaGrassa J.
Department of Psychiatry, Brookdale Hospital Medical Center, Brooklyn, NY 11212.
Lithium combined with phenelzine alleviated the symptoms of four severely depressed patients. Previously, all four patients had failed to respond to tricyclic antidepressants, and three had not responded to monoamine oxidase inhibitors.
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Am J Psychiatry. 1985 May;142(5):619-23.
Efficacy of lithium-tranylcypromine treatment in refractory depression.Price LH, Charney DS, Heninger GR.
Twelve inpatients with major depression refractory to at least two controlled antidepressant trials had tranylcypromine added to ongoing lithium treatment. Eleven patients showed reliable improvement in nurses' depression ratings compared with a prior trial of lithium added to an antidepressant that was not a monoamine oxidase inhibitor (MAOI). Eight patients were blindly judged much or very much improved, and all 12 patients improved sufficiently to be discharged. Preclinical studies of conjointly administered lithium and MAOIs suggest that central serotonergic pathways may mediate this robust clinical effect.
poster:Caedmon
thread:630791
URL: http://www.dr-bob.org/babble/20060408/msgs/631427.html