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Re: MAOIs and orthostatic hypotension

Posted by evenintherain on March 4, 2010, at 7:04:36

In reply to Re: MAOIs and orthostatic hypotension, posted by CrAzYmEd on March 4, 2010, at 4:58:47

Hi,

i was wondering if you had an example of an NRI that works w/maoi? sorry if i am being dense but i guess i'm not sure what an NRI is.

all i could find as a true NRI (not SNRI) was Strattera? and it comes with this warning:

"STRATTERA should not be taken with an MAOI, or within 2 weeks after discontinuing an MAOI. Treatment with an MAOI should not be initiated within 2 weeks after discontinuing STRATTERA. With other drugs that affect brain monoamine concentrations, there have been reports of serious, sometimes fatal reactions (including hyperthermia, rigidity, myoclonus, autonomic instability with possible rapid fluctuations of vital signs, and mental status changes that include extreme agitation progressing to delirium and coma) when taken in combination with an MAOI. Some cases presented with features resembling neuroleptic malignant syndrome. Such reactions may occur when these drugs are given concurrently or in close proximity"

i know that some people on here have taken Ritalin with their MAOI, even though it is technically counter-indicated due to "risk of hypertensive crisis." i assume that is just because it generally increases blood pressure, which is sort of what we are looking for here. but i would think the risk the would still exist that if you DID have a tyramine reaction it may be worse?

but you are saying the NRI would actually REDUCE the risk of a hypertensive crisis due to tyramine. that sounds very helpful. how does that work?

currently i am getting orthostatic hypotension. i take .2mg of fludrocortisone acetate (florinef), and drink lots of gatorade. neither have been much help. but i assume this is because i am still working my dosage up (just got to 30mg). most people seem to think the orthostatic hypotension goes away once you get on a steady dose?

 

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