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Re: Do I need a washout? gpznos

Posted by SLS on February 19, 2013, at 12:05:06

In reply to Re: Do I need a washout? SLS, posted by gpznos on February 19, 2013, at 8:14:22

> > > Hi
> > > I am planning on starting Marplan very soon. My question is which of the following drugs need to be discontinued and also if I need any washout period:
> > >
> > > Nortriptyline 135 mg
> > > Lexapro 10 mg
> > > Mirtazapin 15 mg
> > > Lithium 600 mg
> > > Valdoxan 25 mg
> > >
> >
> > Lexapro is the drug that will produce a dangerous reaction when combined with Marplan (serotonin syndrome). Even though you are taking a low dosage of Lexapro, I would still recommend a 10 - 14 day waiting period between your last dose of Lexapro and your first dose of Marplan. If you wanted to, you could actually keep the nortriptyline, lithium, and Valdoxan. I am not so sure about mirtazapine, and would not recommend that you continue taking it. By the way, although 15 mg/day of mirtazapine is great for sleep, it won't often help with depression. Most doctors don't appreciate the effectiveness of mirtazapine because they don't use dosages that are high enough to produce an antidepressant response. 45 - 90 mg/day is what I consider to be therapeutic.
> >
> > Good luck.
> >
> >
> > - Scott
> Thanks Scott
> 10-14 days seems like a long time as I have understood the half-time of Lexapro is 30 hours - or have these two "times" nothing to do with eachother? Forgive my ignorance, I just want to get started ASAP.
> Do you think I could continue Lithium and Nort in the previous doses or should they just be taken as add-ons?
> gpznos

Some people like to use the rule of thumb of waiting 5 half-lives to insure that the majority of drug has left the body. Add a couple of days for good luck.

My case is a rather stubborn one. I am accustomed to being on lithium and nortriptline in combination with Parnate or Nardil. Do you think your doctor would let you do that?

- Scott

Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw




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