![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by SLS on November 4, 2003, at 13:52:07
Hi.
I'm considering asking my doctor to look into the possibility of combining Parnate + Remeron. I have never heard of this being done, but I am getting pretty desperate.
Any feedback would be welcome!
- Scott
Posted by crazychickuk on November 4, 2003, at 14:09:05
In reply to Anyone ever combine MAOI + Remeron ???, posted by SLS on November 4, 2003, at 13:52:07
Hi there, out of curisoity what do u suffer with? I am currently taking 30mg remeron and i feel it has stopped working as my panick attacks and obsessions are at their worst so far.. i have asked for another medication but my doctor and i both said not another ssri snri or trylic as i have had bad reactions with all, i was going to ask about an maoi too.. ?
Posted by SLS on November 4, 2003, at 14:55:18
In reply to Re: Anyone ever combine MAOI + Remeron ???, posted by crazychickuk on November 4, 2003, at 14:09:05
> Hi there, out of curisoity what do u suffer with? I am currently taking 30mg remeron and i feel it has stopped working as my panick attacks and obsessions are at their worst so far.. i have asked for another medication but my doctor and i both said not another ssri snri or trylic as i have had bad reactions with all, i was going to ask about an maoi too.. ?
I suffer from chronic severe depression that is probably bipolar. There aren't too many things that I haven't tried. If you haven't yet tried a MAOI, I think it might be a reasonable option for you right now. Nardil in particular can exert an antiobsessional effect.I'm currently taking 60mg of Remeron in combination with Effexor and imipramine, and seem to be tolerating it very well. I may go up to 75 next week if nothing encouraging is happening by then. I don't think it makes sense to rule-out Remeron until one has taken 60mg for at least three weeks. Doctors in Europe tend to utilize Remeron more agressively, prescribing dosages as high as 90-120mg.
I will be curious to know in what direction your treatment goes. What are some of the things you have been thinking about trying?
- Scott
Posted by cybercafe on November 4, 2003, at 15:59:16
In reply to Anyone ever combine MAOI + Remeron ???, posted by SLS on November 4, 2003, at 13:52:07
> Hi.
>
> I'm considering asking my doctor to look into the possibility of combining Parnate + Remeron. I have never heard of this being done, but I am getting pretty desperate.
>
> Any feedback would be welcome!
>sounds like serotonin syndrome ... i wouldn't do it ... from what i know now
Posted by TJO on November 4, 2003, at 16:48:22
In reply to Anyone ever combine MAOI + Remeron ???, posted by SLS on November 4, 2003, at 13:52:07
Hi Scott,
I ran a quick search. What i found didn't look very encouraging. I'd be intersted to know what the possibly fatal side effects were, how often the occur, etc.http://www.rxbest.com/remeron.htm
From the above:Do not take Remeron if you are currently taking, or have taken within the last 14 days, a monoamine oxidase inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate). Remeron may increase the effects of other drugs that cause drowsiness, including other antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves. Drugs other than those listed here may also interact with Remeron. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.
http://www.prescription-drugs.us/remeron.htm
From the above:
Interactions:
Do not take Remeron if you are currently taking, or have taken within the last 14 days, a monoamine oxidase inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate). Remeron may increase the effects of other drugs that cause drowsiness, including other antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves. Drugs other than those listed here may also interact with Remeron. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.http://support4hope.com/medications/index.htm
From the above:You should also avoid Remeron if you are taking the antidepressants Nardil or Parnate.
Serious, sometimes fatal reactions have been known to occur when drugs such as Remeron are taken in combination with other drugs known as MAO inhibitors, including the antidepressants Nardil and Parnate. Never take Remeron with one of these drugs or within 14 days of discontinuing therapy with one of them; and allow at least 14 days between stopping Remeron and starting an MAO inhibitor.
If you develop "flu-like" symptoms, a sore throat, chills or fever, mouth sores, or any other signs of infection, call your doctor; these symptoms may signal a serious underlying condition.
Remeron tends to raise cholesterol levels in some people. If you have a cholesterol problem, be sure to mention it to your doctor before starting therapy with Remeron.
Remeron should be used with caution if you have active liver or kidney disease, or heart or blood pressure problems. Also be sure to tell your doctor if you have a history of seizures, mania (extremely high spirits), hypomania (mild excitability), drug use, or any other physical or emotional problems.hope this helps :)
Tammy
Posted by SLS on November 4, 2003, at 19:27:39
In reply to Re: Anyone ever combine MAOI + Remeron ???, posted by cybercafe on November 4, 2003, at 15:59:16
> > I'm considering asking my doctor to look into the possibility of combining Parnate + Remeron. I have never heard of this being done, but I am getting pretty desperate.
> > Any feedback would be welcome!
> sounds like serotonin syndrome ... i wouldn't do it ... from what i know now
Thanks, Cybercafe.Did you experience an adverse event involving serotonin syndrome?
I would like to remain cautious on this one. However, from a simplistic model, I don't think serotonin syndrome should be a problem. From what I've read, Remeron does not inhibit the reuptake of serotonin, nor does it stimulate serotonergic receptors. It actually blocks the stimulation 5-HT2 and 5-HT3 receptors, which might actually protect from the development of the syndrome. I am more concerned with Remeron's ability to block presynaptic NE alpha2 autoreceptors, in that it might act synergistically with an MAOI to increase levels of synaptic NE and cause a rise in blood pressure.
- Scott
Posted by cybercafe on November 4, 2003, at 23:44:48
In reply to Re: Anyone ever combine MAOI + Remeron ??? » cybercafe, posted by SLS on November 4, 2003, at 19:27:39
> > > I'm considering asking my doctor to look into the possibility of combining Parnate + Remeron. I have never heard of this being done, but I am getting pretty desperate.
>
> > > Any feedback would be welcome!
>
> > sounds like serotonin syndrome ... i wouldn't do it ... from what i know now
>
>
> Thanks, Cybercafe.
>
> Did you experience an adverse event involving serotonin syndrome?
>
> I would like to remain cautious on this one. However, from a simplistic model, I don't think serotonin syndrome should be a problem. From what I've read, Remeron does not inhibit the reuptake of serotonin, nor does it stimulate serotonergic receptors. It actually blocks the stimulation 5-HT2 and 5-HT3 receptors, which might actually protect from the development of the syndrome. I am more concerned with Remeron's ability to block presynaptic NE alpha2 autoreceptors, in that it might act synergistically with an MAOI to increase levels of synaptic NE and cause a rise in blood pressure.
sorry dude, i take it back. i always thought mirtazapine was a SRI ... but i just read an article on MAOIs which seems to indicate it's safe (and even used to treat serotonin syndrome, on occasion)..... https://www.currentpsychiatry.com/2002 06/06 02 maoi.asp
Posted by crazychickuk on November 5, 2003, at 3:43:06
In reply to Re: Anyone ever combine MAOI + Remeron ???, posted by cybercafe on November 4, 2003, at 23:44:48
Well the professionals have posted on many sites ''do not take remeron with or within 14 days of taking an maoi'' weather it is a ssri or not.. still i dont want to risk it, my mind is bugged enough as it is.. :(
Posted by SLS on November 5, 2003, at 7:45:18
In reply to Re: Anyone ever combine MAOI + Remeron ???, posted by cybercafe on November 4, 2003, at 23:44:48
... but i just read an article on MAOIs which seems to indicate it's safe (and even used to treat serotonin syndrome, on occasion)..... https://www.currentpsychiatry.com/2002 06/06 02 maoi.asp
I really appreciate the URL, Cybercafe. Unfortunately, I can't get the link to work. Do you think you could direct me to some of the literature describing the combination of MAOIs with Remeron? Thanks.
- Scott
Posted by cybercafe on November 6, 2003, at 18:38:58
In reply to Re: Anyone ever combine MAOI + Remeron ??? » cybercafe, posted by SLS on November 5, 2003, at 7:45:18
> ... but i just read an article on MAOIs which seems to indicate it's safe (and even used to treat serotonin syndrome, on occasion)..... https://www.currentpsychiatry.com/2002 06/06 02 maoi.asp
>
>
> I really appreciate the URL, Cybercafe. Unfortunately, I can't get the link to work. Do you think you could direct me to some of the literature describing the combination of MAOIs with Remeron? Th
sorry dude i am having computer problems with getting information ... BUT i can tell you it came from a VERY RECENT post (2 days ago?) by lostboyinnc in the alt.support.depression.medication newsgroup
www.google.com
click on groups
type in
alt.support.depression.medication
click on "search in ASDM only"
type in currentpsychiatry.com or lostboy or something! the title was something about MAOIs ...sorry i can't cut and paste dude :(
Posted by SLS on November 6, 2003, at 19:41:37
In reply to Re: Anyone ever combine MAOI + Remeron ???, posted by cybercafe on November 6, 2003, at 18:38:58
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.