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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Roslynn on May 1, 2008, at 16:11:57
Hi everyone,
Does anyone know if you have to stop tricyclics before taking Emsam? I know there is a 5-week washout period for Prozac. But does one need to washout the TCAs also? I am afraid to be without an antidepressant for any length of time.
Thank you for any thoughts,
Roslynn
Posted by Nadezda on May 2, 2008, at 11:27:36
In reply to tricyclics with Emsam?, posted by Roslynn on May 1, 2008, at 16:11:57
Definitely need a washout period with tricyclics.
It could be really dangerous to take them with Maois. Serotonin syndrome is a real possiblity.
Check with your pdoc before you take any combination of other meds with Maois.
Good luck.
Nadezda
Posted by undopaminergic on May 2, 2008, at 13:58:04
In reply to tricyclics with Emsam?, posted by Roslynn on May 1, 2008, at 16:11:57
Clomipramine and impipramine in combination with a MAOI (such as EMSAM) can lead to fatal serotonin syndrome. Of course, it does depend on dose. Low doses of selegiline (the active ingredient of EMSAM) have been used safely with serotonergic drugs (citalopram in particular), but moderately severe reactions have occurred in a few cases.
The other tricyclics have no serotonergic properties; they can be used with MAOIs, although it's still prudent to closely monitor cardiovascular parameters during the initial period after starting the combination.
Posted by Roslynn on May 2, 2008, at 15:57:18
In reply to Re: tricyclics with Emsam?, posted by undopaminergic on May 2, 2008, at 13:58:04
> Clomipramine and impipramine in combination with a MAOI (such as EMSAM) can lead to fatal serotonin syndrome. Of course, it does depend on dose. Low doses of selegiline (the active ingredient of EMSAM) have been used safely with serotonergic drugs (citalopram in particular), but moderately severe reactions have occurred in a few cases.
>
> The other tricyclics have no serotonergic properties; they can be used with MAOIs, although it's still prudent to closely monitor cardiovascular parameters during the initial period after starting the combination.Thanks for your helpful response. The reason I am concerned is that one of my meds is desipramine which seems to be working a little and I would be worried about going off it to try emsam)
Do you by any chance know if lithium and seroquel are ok to take with MAOIs?
Thank you for your help!
Roslynn
Posted by undopaminergic on May 2, 2008, at 18:18:45
In reply to Re: tricyclics with Emsam?, posted by Roslynn on May 2, 2008, at 15:57:18
>
> Do you by any chance know if lithium and seroquel are ok to take with MAOIs?
>I know that both have been used with MAOIs without problems. However, there is a great deal of variation in how different people respond to different drugs and combinations.
Posted by SLS on May 2, 2008, at 18:34:45
In reply to tricyclics with Emsam?, posted by Roslynn on May 1, 2008, at 16:11:57
> Hi everyone,
>
> Does anyone know if you have to stop tricyclics before taking Emsam?I would not recommend combining most tricyclics with an MAOI. There are two that a relatively safe, though. These are desipramine and nortriptyline. Trimipramine might be another TCA safe to combine with an MAOI. I found that imipramine + Nardil produced a moderate serotonin syndrome.
- Scott
Posted by Roslynn on May 2, 2008, at 18:40:55
In reply to Re: tricyclics with Emsam?, posted by SLS on May 2, 2008, at 18:34:45
Thanks everyone for your help!
Roslynn
This is the end of the thread.
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