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Re: Buspar vivid/terrible nightmares? SLS?

Posted by undopaminergic on September 26, 2022, at 11:13:14

In reply to Re: Buspar vivid/terrible nightmares? SLS? PeterMartin, posted by Jay2112 on September 25, 2022, at 19:17:36

> One combo I have heard of is an MAOI + Buspar + a dopamine agonist. I don't know if any of the dopamine agonists would be safe with Marplan or any MAOI? I have never heard of contraindications between them.

It depends on what you mean by dopamine agonists. Direct agonists like pramipexole and ropinirole should be perfectly safe, because they don't elevate serotonin or noradrenaline. Indirect dopamine agonists that function as reuptake inhibitors, like methylphenidate, are generally safe unless they also inhibit serotonin reuptake. Amphetamines are more risky, because they act like tyramine -- releasing noradrenaline -- and this can potentially lead to hypertensive crises. However, with caution, amphetamines can be a great way to augment a MAOI.

Cocaine is a serotonin reuptake inhibitor, so in theory it should be dangerous to combine with a MAOI. However, I wonder why I've never heard of any problems with this combination. Maybe it's because cocaine has a short half-life, so it wears off before it produces any dangerous serotonin syndrome.

> I guess the only concern would be blood pressure.

And serotonin toxicity. Incidentally, sometimes a little elevation of blood pressure is a good thing, because MAOIs often produce hypotension.





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