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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by tumnus on June 7, 2003, at 1:29:59
I have read that taking ephedrine and MAOI's was dangerous. Does anyone know the side effects of taking Ma Haung and Lexapro or Celexa? The sites I found recommended not to but didn't say why. I also couldn't find a site I could trust that would give me information on the interaction.
Posted by Questionmark on June 7, 2003, at 3:39:37
In reply to SSRI's and Ephedrine, posted by tumnus on June 7, 2003, at 1:29:59
> I have read that taking ephedrine and MAOI's was dangerous. Does anyone know the side effects of taking Ma Haung and Lexapro or Celexa?
It's fine w/ an SSRI. Or, it's basically as fine as it would be if not on anything.
Posted by linkadge on June 7, 2003, at 3:57:20
In reply to Re: , posted by Questionmark on June 7, 2003, at 3:39:37
Some people can experience very strange effects from combining SSRI's with stimulant drugs. Many people note a reaction to smoking+SSRI's.
Since the serotogenic and dopamanergic systems generally work inversly, stimulating both at once can be dangerous, especially since Ephedrine can be hazardous alone. Doing so, can also increase the likelyhood of serotonin syndrome.
I would take caution, or at lease take a small trial dose combination before delving right in.
Linkadge
Posted by Questionmark on June 7, 2003, at 4:42:23
In reply to Re: Not nessarily , posted by linkadge on June 7, 2003, at 3:57:20
> Some people can experience very strange effects from combining SSRI's with stimulant drugs. Many people note a reaction to smoking+SSRI's.
>
> Since the serotogenic and dopamanergic systems generally work inversly, stimulating both at once can be dangerous, especially since Ephedrine can be hazardous alone. Doing so, can also increase the likelyhood of serotonin syndrome.
>
> I would take caution, or at lease take a small trial dose combination before delving right in.
>
> LinkadgeWell, you may have a good point.
Two clarifications though: 1) i'm pretty sure ephedrine does not directly affect DA systems at all-- it's just an adrenergic agonist.
2) Ephedrine is not hazardous alone if the person is using reasonable amounts-- thats my opinion at least.
Posted by tumnus on June 7, 2003, at 10:31:03
In reply to Re: Not nessarily , posted by linkadge on June 7, 2003, at 3:57:20
What is seritonin syndrome? I was diagnosed about three months ago and I don't know much regarding the medications only what I read in the drug pamphlets. Know of any good websites or resources that would help? Another question completely off the subject, is a Pdoc a psychiatric doctor?
Thanks for the help.
> Some people can experience very strange effects from combining SSRI's with stimulant drugs. Many people note a reaction to smoking+SSRI's.
>
> Since the serotogenic and dopamanergic systems generally work inversly, stimulating both at once can be dangerous, especially since Ephedrine can be hazardous alone. Doing so, can also increase the likelyhood of serotonin syndrome.
>
> I would take caution, or at lease take a small trial dose combination before delving right in.
>
> Linkadge
Posted by noa on June 7, 2003, at 14:51:52
In reply to SSRI's and Ephedrine, posted by tumnus on June 7, 2003, at 1:29:59
I am not an expert, but personally, what I'd be afraid of is that both are so stimulating and the synergistic effects might get out of control.
Also, I hope you have been following the news stories about athletes and ephedra, and I think it has been banned in baseball after the death of that young player.
Posted by linkadge on June 7, 2003, at 21:16:28
In reply to Re: SSRI's and Ephedrine » tumnus, posted by noa on June 7, 2003, at 14:51:52
Basically serotnin sydrome is a illness caused by to much serotonin in the synapse. Generally it occurs abruptly, and creates side effects like:
Extreme anxiety and agitation
Extreme panic reaction
Delusions, hallucinations,
Blood presure increase and heart rate.
Rapid fluctutations in body temperature
etc, etc.
The chance of getting this reaction to an SSRI alone is extremely slim. The problem can occur when pairing serotogenic meds, and some others.Generally when taking an SSRI, one should be cautious about adding other psychiatric meds, stimulants etc. I suffered serotonin syndrome when combining Celexa and St. John's wort - coming close to death.
Although ephedra is not considered a serotogenic med, on should be cautious with it, as activation of other neurotrasmitter systems can lead to increase serotonin. Ie SSRI and Deprenly.
There is no need to be worried but do speak to a sensible pharmacist before adding any psyhatric meds.
That said there may be many taking the combination.Linkadge
Posted by Caleb462 on June 7, 2003, at 21:23:19
In reply to Re: SSRI's and Ephedrine, posted by linkadge on June 7, 2003, at 21:16:28
> Although ephedra is not considered a serotogenic med, on should be cautious with it, as activation of other neurotrasmitter systems can lead to increase serotonin. Ie SSRI and Deprenly.
>Well deprenyl, while primarily an MAO-B inhibitor, also inhibits MAO-A, particularly at doses above 10 mg. So this would explain an SSRI + deprenyl reaction.
To the original poster, I would be cautious about combining an SSRI + ephedrine, and start with a small dose to see how your body reacts - but in general, SSRI + ephedrine should be a safe combination. And you should always be cautious when using ephedrine, SSRI or not.
> There is no need to be worried but do speak to a sensible pharmacist before adding any psyhatric meds.
>
>
> That said there may be many taking the combination.
>
> Linkadge
>
>
>
>
>
>
Posted by djmmm on June 8, 2003, at 8:24:26
In reply to Re: Not nessarily , posted by Questionmark on June 7, 2003, at 4:42:23
> > Some people can experience very strange effects from combining SSRI's with stimulant drugs. Many people note a reaction to smoking+SSRI's.
> >
> > Since the serotogenic and dopamanergic systems generally work inversly, stimulating both at once can be dangerous, especially since Ephedrine can be hazardous alone. Doing so, can also increase the likelyhood of serotonin syndrome.
> >
> > I would take caution, or at lease take a small trial dose combination before delving right in.
> >
> > Linkadge
>
> Well, you may have a good point.
> Two clarifications though: 1) i'm pretty sure ephedrine does not directly affect DA systems at all-- it's just an adrenergic agonist.
> 2) Ephedrine is not hazardous alone if the person is using reasonable amounts-- thats my opinion at least.The stimulating effects from ephedrine are blocked by dopamine antagonists that effect D1 and D2, so the dopamine system is involved, but its primary effect is on the alpha-adrenergic receptors...I would suggest pseudoephedrine, but ephedrine is typically safe, but like every drug, if taken in excess, or in combination with other stimulants, you increase the risk of side-effects (cardio and otherwise)
Posted by Questionmark on June 9, 2003, at 0:21:40
In reply to Re: SSRI's and Ephedrine » tumnus, posted by noa on June 7, 2003, at 14:51:52
You all mentioned some important things/ made good points. But i wanted to comment on a couple things.
> Also, I hope you have been following the news stories about athletes and ephedra, and I think it has been banned in baseball after the death of that young player.
Yes, but how much ephedra/ephedrine was this person taking? i could be wrong but i imagine it was more than a reasonable amount, especially combined with the potential of overheating or dehydration. i really believe that most of the fatal or harmful reactions with ephedra/ephedrine occurred from taking an excessively high dose or from combining w/ sh** it should not be combined with. i've taken ephedra numerous times at no more than moderate doses and have never been more stimulated than i can be on a few cups of coffee at most (& nowhere near the stimulation i get from Adderall or methylphenidate). Again just start w/ low dose and exercise caution.
> The stimulating effects from ephedrine are blocked by dopamine antagonists that effect D1 and D2, so the dopamine system is involved, but its primary effect is on the alpha-adrenergic receptors...
Okay, i'm mostly ignorant here, so i may be wrong, but this is the kind of stuff that makes me really question the validity of psychiatric & pharmacological research. Any dopamine D1 & D2 antagonist is going to greatly nullify any kind of stimulating effects-- whether from a DA agonist or otherwise-- it seems like at least. i mean, if you inhaled/injected some epinephrine after taking a DA antagonist, wouldn't the stimulating effects still be significantly diminished? That said, if the same kind of analysis was used to determine that ephedrine is an adrenergic agonist, then maybe it's really just a DA agonist and not an adrenergic one. So... i'm confused.
How trustworthy is information on the pharmacological activity/profile of various substances? Anyone have an idea? Am i missing something that makes these tests more valid?
Posted by Stacey fu on June 11, 2003, at 15:53:50
In reply to Re: Not necessarily, posted by Questionmark on June 9, 2003, at 0:21:40
> i really believe that most of the fatal or harmful reactions with ephedra/ephedrine occurred from taking an excessively high dose or from combining w/ sh** it should not be combined with. i've taken ephedra numerous times at no more than moderate doses and have never been more stimulated than i can be on a few cups of coffee at most (& nowhere near the stimulation i get from Adderall or methylphenidate). Again just start w/ low dose and exercise caution.
Hmmm, interesting. Are you ADHD? I found that when I was taking Ephedra, 25-35 mg. a day, it was a very stimulating and euphoric experience for me. (But also very anxiety producing) When I take my Concerta, 36 mg. or short acting methylphenidate 20 mg. I don't get a charge from it at all. I think it largely depends on your brain chemistry. People with ADHD are supposed to have a deficit of dopamine, and increasing the available amount of dopamine in the brain through the use of psychostimulants has a calming effect. So since Ephedra is primarily an adrenergic, it would make sense that it is so anxiety producing and stimulating for me, unless it's just a slight hypersensitivity reaction. I would be interested to know if any others with
AD(H)D had a similar experience with Ephedra. And does anybody know the Biochemical reason why this happens?Thanks!
Stacey
>
Posted by Questionmark on June 16, 2003, at 6:45:18
In reply to Re: Not necessarily, posted by Stacey fu on June 11, 2003, at 15:53:50
> > i really believe that most of the fatal or harmful reactions with ephedra/ephedrine occurred from taking an excessively high dose or from combining w/ sh** it should not be combined with. i've taken ephedra numerous times at no more than moderate doses and have never been more stimulated than i can be on a few cups of coffee at most (& nowhere near the stimulation i get from Adderall or methylphenidate). Again just start w/ low dose and exercise caution.
>
>
> Hmmm, interesting. Are you ADHD? I found that when I was taking Ephedra, 25-35 mg. a day, it was a very stimulating and euphoric experience for me. (But also very anxiety producing) When I take my Concerta, 36 mg. or short acting methylphenidate 20 mg. I don't get a charge from it at all.Wow, that is interesting. i get definite stimulation and euphoria from any stimulant: caffeine, ephedra, methylphenidate, amphetamines. i'd have to say that methylphenidate is definitely the most "calming" for me, in that sit-down-and-focus-on-whatever sense of calming (but i could still do something physical and have more stamina or whatever than otherwise if i wanted to)-- maybe that's what you mean? i guess it depends on what sense we're talking about, as "calming" and "stimulating" aren't adequate words in themselves for this. i'm pretty sure i have ADHD (inattentive type), though the boundaries and specificity of what constitutes "ADHD" are becoming more and more blurry to me (yes i do believe that it exists-- but maybe much more of a general spectrum than we realize).
> I think it largely depends on your brain chemistry. People with ADHD are supposed to have a deficit of dopamine, and increasing the available amount of dopamine in the brain through the use of psychostimulants has a calming effect.
Well, catecholamine "deficit" (or whatever) i think it is, right? Which means could be either dopamine or norepinephrine or both. i don't think they've really come to a consensus.
> So since Ephedra is primarily an adrenergic, it would make sense that it is so anxiety producing and stimulating for me, unless it's just a slight hypersensitivity reaction.
Huh. Yeah, i wonder if that's the major difference-- adrenergic potentiation correlates with increased stimulation, while increased DA activity correlates with the "calming" kind of effect. i wonder. Ah heck i duno.
> I would be interested to know if any others with
> AD(H)D had a similar experience with Ephedra. And does anybody know the Biochemical reason why this happens?Yes, i'm curious too.
This is the end of the thread.
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