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Re: Amitriptyline and percentages of SERT blockade

Posted by undopaminergic on April 11, 2020, at 12:00:50

In reply to Re: Amitriptyline and percentages of SERT blockade, posted by linkadge on April 11, 2020, at 10:39:45

> 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.

Maybe, yes, but in all cases, it is the dose that makes the poison. Eg. if adding 50 mg of sertraline under MAO-A inhibition would precipitate serotonin syndrome, 5 mg may still be all right.

> 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.

What about cocaine? It is a SRI for sure, but I never heard of serotonin syndrome from it. Perhaps it is self-limiting due to coke's short half-life?





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