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Re: Viloxazine (QelBree) now approved for adult ADHD

Posted by SLS on May 6, 2022, at 0:35:27

In reply to Viloxazine (QelBree) now approved for adult ADHD, posted by PeterMartin on May 5, 2022, at 16:04:47

> Viloxazine, which was used as an anti-depressant in through the early 00s in Europe, was just approved for adult ADHD. The drug had been approved for ADHD in children by the FDA last year.
>
> I know some people are familiar w/ this drug from it's former days an antidepressant (SLS> Saw you knew about it in the early 00s after searching this forum). It's typically thought of as a NE reuptake inhibitor, but I guess it does act a bit on serotonin as well.
>
> Would it be possible to use this drug in while on an MAOI? I'm still on Marplan and I'm also taking methylphenidate at a pretty high dose. I had high hopes for desipramine as an adjunct (instead of ritalin), but it caused extreme sweating and rapid pulse. Strattera, the other common NRI, sent me into a depression so I didn't have any luck there either.
>
> I'd be interested in trying this medicine in the hope it might kickstart some motivation which I've been lacking lately. How likely is this medicine to cause serotonin syndrome if used in combo w/ an MAOI (Marplan/Nardil)?
>
> Thanks, and if anyone has personal experience w/ the drug at all I'd love to hear.


Historically, there are a few tricyclics that have been used safely in combination with a MAOI. For me, adding Nardil to nortriptyline (with Lamictal and lithium) was magic. In the past, my best results came from combining a MAOI combined with a TCA.

This is the thing, though. Combining a MAOI with a TCA that strongly inhibits the reuptake of serotonon is very dangerous. It more often than not triggers a hyperserotonergic state known as serotonin syndrome.

alae is Serotonin Syndrome. Because of this, doctors favor using the secondary amine metabolite pf a TCA/ of the tertiary amine parent drugs (desipramine andnortruptulijijne that are produced from tertiary amines .e.g. nortriptyline or desipramine. These are secondary amines rather than tertiary. Each is the product of an enzymatic cleaving of the molecule. What's left can't touch serotonin.


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URL: http://www.dr-bob.org/babble/20220128/msgs/1119660.html