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Re: Amitriptyline and percentages of SERT blockade

Posted by linkadge on April 11, 2020, at 10:39:45

In reply to Re: Amitriptyline and percentages of SERT blockade linkadge, posted by Skeletor on April 10, 2020, at 17:21:58

Yeah, cyproheptadine is structurally similar to the TCAs. It has similar serotonin, histamine, acetylcholine blocking effects and some (very weak serotonin reuptake inhibition) and is useful for serotonin syndrome.

Most psychiatrists would still likely NOT prescribe amitriptyline with an MAOI, but Gillman is supposedly an expert in this field and his clinical / research experience is important.

I wonder if depression severity correlates with the likelihood of serotonin syndrome. Not that depression is really conclusively linked to low serotonin, but for some (with really low serotonin levels) combining SSRIs and MAOIs may not lead to a problem.

Interestingly, coffee and tobacco can inhibit MAO. Smokers probably have a ~50% reduction in MAO levels yet I've never heard of smoking causing serotonin syndrome with SSRIs.





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