Psycho-Babble Medication Thread 12388

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Prozac and low dose Selegiline

Posted by Lynne on October 1, 1999, at 9:26:50

Can these two drugs be taken together 20mgs Prozac with 5 mgs of Selegiline? The prozac makes me so tired I thought the Selegiline would give me some energy. Any thoughts?I have not tried this combo yet.

 

Re: Prozac and low dose Selegiline

Posted by jd on October 2, 1999, at 20:50:41

In reply to Prozac and low dose Selegiline, posted by Lynne on October 1, 1999, at 9:26:50

Personally, I'd be extremely nervous about mixing these two: MAO inhibitors and SSRIs have been known to cause serious (even fatal) problems when combined--you'd run the risk of a serotonin syndrome or hypertensive crisis. Selegiline is *perhaps* not as dangerous in this way as Nardil or Parnate, but I'd say it's hardly advisable unless you had very good proof otherwise. There must be a safer way to increase your energy level--What does your doctor say? BTW, have you considered taking Prozac in the evening instead?
Best,
jd

> Can these two drugs be taken together 20mgs Prozac with 5 mgs of Selegiline? The prozac makes me so tired I thought the Selegiline would give me some energy. Any thoughts?I have not tried this combo yet.

 

Re: Prozac and low dose Selegiline

Posted by JohnL on October 3, 1999, at 5:58:04

In reply to Prozac and low dose Selegiline, posted by Lynne on October 1, 1999, at 9:26:50

> Can these two drugs be taken together 20mgs Prozac with 5 mgs of Selegiline? The prozac makes me so tired I thought the Selegiline would give me some energy. Any thoughts?I have not tried this combo yet.

There have indeed been clinical studies with combined Prozac and Selegiline. The dosages were not specified in the abstracts however. The patients in the studies were elderly and were already taking Selegiline for parkinson's. There were no adverse reactions beyond what would be expected from either drug alone. There has been mention of adverse reactions in other studies, but they were rare and likely dose-related. I tried Selegiline at 5mg with 20 Prozac for two weeks and did get the energy boost you're looking for. I changed my mind midstream and wanted to try something else first, but may come back to Selegiline+Prozac for another go-round if my current treatment disappoints. Selegiline+Prozac is generally safe, but slow titration and caution is advised at higher doses.

 

Re: Prozac and low dose Selegiline

Posted by Adam on October 4, 1999, at 19:07:18

In reply to Prozac and low dose Selegiline, posted by Lynne on October 1, 1999, at 9:26:50

The literature I have seen indicates Prozac is USUALLY safe in combination with selegiline. Try it and see what happens. It's probably worth it.
Low dose selegiline seems to have a number of very nice properties, and might, quite literally, make you live longer and
protect your neurons. It seems to, along with its robust dopaminergic effects, boost the level of certain antioxidant
enzymes, (as well as tyrosine hydroxylase, interestingly).

I have wondered sometimes if a combination of an SSRI, reboxetine, AND low dose selegiline wouldn't be a really effective
combination for depression. It would be like Effexor plus, maybe, and perhaps might be a good alternative for those who
don't want to deal with an MAOI like tranylcypromine or phenelzine.

Just a thought.

> Can these two drugs be taken together 20mgs Prozac with 5 mgs of Selegiline? The prozac makes me so tired I thought the Selegiline would give me some energy. Any thoughts?I have not tried this combo yet.

 

selegiline and hypericum

Posted by Jef Kazak on August 24, 2000, at 8:54:18

In reply to Prozac and low dose Selegiline, posted by Lynne on October 1, 1999, at 9:26:50

Can selegiline be taken together with hypericum (St. John's Wort)? I've only just started taking selegiline at very low doses, 2.5 mg per day, but before I liked the effect of hypericum at low doses too (300mg per day, taken before bedtime). Since I've read that hypericum acts like a SSRI or a IMAO-A at the recommendable dose of 900mg per day, I was wondering it it's safe to take the two together at low doses.

 

Re: selegiline and hypericum

Posted by Sunnely on August 27, 2000, at 23:24:02

In reply to selegiline and hypericum, posted by Jef Kazak on August 24, 2000, at 8:54:18

> Can selegiline be taken together with hypericum (St. John's Wort)? I've only just started taking selegiline at very low doses, 2.5 mg per day, but before I liked the effect of hypericum at low doses too (300mg per day, taken before bedtime). Since I've read that hypericum acts like a SSRI or a IMAO-A at the recommendable dose of 900mg per day, I was wondering it it's safe to take the two together at low doses.

Hi Jef,

I have not encountered in the literature report of bad interaction between St. John's wort (SJW) and selegiline (Eldepryl). Theoretically, it is possible. SJW is purported to have monoamine oxidase inhibiting (MAOI) action. Combining medications with MAOI action (? e.g., SJW), even selective MOAI B like selegiline, can be potentially dangerous since they could lead to serotnin syndrome. Cases of serotonin syndrome from combination of selegiline and antidepressants have been reported. Also, cases of serotonin syndrome from combination of SJW and SSRIs have been reported.

Incidentally, in one recent study, the use of selegiline transdermal system (STS) or patch form, was found safe and effective treatment for patients with major depressive disorder and may have a rapid onset of action.

References:

1. Selegiline and Serotonin Syndrome. In: Psychiatry Drug Alerts, July 1997.

2. Natural Medicines: Comprehensive Database, 2000. Published by Therapeutic Research Faculty, Stockton, CA.

3. New data presented on lithium, transdermal selegiline. In: Psychopharmacology Update, August 2000.

 

Re: selegiline and hypericum

Posted by JohnL on August 29, 2000, at 4:34:29

In reply to selegiline and hypericum, posted by Jef Kazak on August 24, 2000, at 8:54:18

> Can selegiline be taken together with hypericum (St. John's Wort)? I've only just started taking selegiline at very low doses, 2.5 mg per day, but before I liked the effect of hypericum at low doses too (300mg per day, taken before bedtime). Since I've read that hypericum acts like a SSRI or a IMAO-A at the recommendable dose of 900mg per day, I was wondering it it's safe to take the two together at low doses.

At the low doses you mentioned, the combination seems fine to me. The risk of overload is always present when combining different meds that increase neurotransmitter levels, but I suspect you would have to be at much higher doses to be of any real concern. Just off the top of my head, I would approach this combo more carefully at say for example 10mg Selegiline or higher, and 900mg SJW or higher, or both. Who knows though, you could possibly even go twice as high as that. I think starting low and increasing doses slowly in small increments is the safe way to go, so that if there are any adverse reactions you can catch them in the early stage before they are serious.
John


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