Posted by Robert_Burton_1621 on March 1, 2015, at 23:05:25
In reply to Re: SSRI withdrawal symptoms really scare me!, posted by baseball55 on March 1, 2015, at 19:55:13
> > what do you mean with "when the combination is taken under supervision"? a serotonin syndrome can happen at any time from what i read. it can kick in weeks after starting the treatment. this is very scary!>
What I mean is that the risk, to the extent that it exists, can be reduced to the negligible if the dosages are handled right.
> I took an SSRI and adderall with no problem. I don't think the combination causes serotonin syndrome. Where did you hear that?
>Good question. Amphetamine acts mostly on noradrenaline and dopamine, and
its serotonergic potential is very weak. There appears to be very little risk of causing serotonin toxicity when combined with an MAOI, for instance (although other risks, like noradrenergic toxicity, are more significant and were probably the cause of the few fatalities associated with the combimation of MAOIs with amphetamines). This does not mean the combination is risk-free; it means that the risk must be limited and monitored if the therapeutic option is to be pursued.Dr Gillman, an international authority on serotonin toxicity, writes that "amphetamine is 50-100 times less potent for serotonin, both as a releaser and reuptake inhibitor, than for dopamine or noradrenaline (see table). Its 5-HT transporter affinity (~3800 nmol) is extremely weak." But he also does note that a rise in central serotonin levels has been documented in animal studies and that "amphetamine exhibits significant toxicity with venlafaxine (probably serotonin toxicity, as opposed to noradrenergic toxicity)". See:
http://www.psychotropical.com/serotonin-toxicity
http://www.psychotropical.com/maois-and-cns-stimulants
poster:Robert_Burton_1621
thread:1077156
URL: http://www.dr-bob.org/babble/20150223/msgs/1077234.html