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MAOI + SNRI? » UgottaHaveHope

Posted by Quintal on April 2, 2007, at 12:34:33

In reply to Re: TCA + MAOI, posted by UgottaHaveHope on April 2, 2007, at 10:28:35

What does he mean by this:

The irony is that mixing a TCA (one which is not also an SRI) with an MAOI makes it safer! This is because the ‘cheese’ reaction (potentially catastrophic hypertension) requires that the provoking dietary component (the amino acid tyramine) must first enter the pre-synaptic nerve, from whence it displaces noradrenaline which then mediates the hypertension. Tyramine is actively moved into the pre-synaptic nerve by the very same ‘reuptake’ mechanism that is blocked by TCAs, which are ‘NRIs’.

Is he saying that it's much more difficult for the tyramine to enter the pre-synaptic nerve once the noradrenaline transporter is blocked, therefore lower risk of hypertensive crisis? Why isn't reboxetine used instead of TCAs - interactions?





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