Posted by psychobot5000 on August 17, 2006, at 18:12:29
In reply to Safe to Combine Selegiline/Remeron?, posted by hgi698 on August 4, 2006, at 17:02:44
> Hi I have a couple questions actually. I am currently taking 45 mg of Remeron (mirtazapine) 20 mg adderall and 25 mg of amisulpride. I was wondering if it is safe to add a low dose of selegiline (5 to 10 mg) to my meds?
Harvard affiliate psychiatrists Alexander Bodkin and Jonathan Cole, experts on MAO inhibitors (Bodkin in particular was involved with the development of EMSAM), consider Remeron/mirtazapine to be safe to use with MAO inhibitors. Since selegiline has only weak MAO-A related activity, at 5-10mg, I should think that the combination of the two would be quite safe.
Having atypical, unmotivated depression myself, I tried the combination several years ago, and it was better than either drug alone, I was still left without motivation--overly relaxed. There were no safety issues during my trial.
But in any case, while those two may be safe, combining them with 20mg Adderall is probably not safe, let alone adding amisulpride. Besides all the other interactions and concerns, that's a lot of dopamine enhancing drugs. It sounds quite dangerous, and I would stay away.
If you're willing to undergo the dietary restrictions, though, I'd suggest (under proper medical supervision) trying a more powerful MAO inhibitor, (phenelzine or tranylcipromine) with Remeron. I wouldn't add them to your current cocktail, but according to Bodkin and Cole, they can safely be augmented with Remeron or most tricyclics.
Relevant Article at:
http://www.currentpsychiatry.com/
"Mao inhibitors: An option worth trying in treatment-resistant cases"
Jonathan O. Cole, MD; J. Alexander Bodkin, MD
Release date: 6/1/2002I hope things go well for you.
P-bot
poster:psychobot5000
thread:673727
URL: http://www.dr-bob.org/babble/20060810/msgs/677486.html