Posted by SLS on March 19, 2006, at 7:09:07
In reply to Scared to start the Parnate, posted by Maxime on March 17, 2006, at 16:48:19
> In fact, what I read was a comparison of how interns, residents, and experienced psychiatrists answered the question, "Can you ever combine MAOIs and SSRIs?" The interns said never, the residents said they'd heard of it being done, the experienced doctors said that they would or had done it.
Despite what the experienced doctors in this survey had to say, I believe that combining Parnate + SSRI is absolutely contraindicated. If one of these doctors actually combined these drugs successfully, I doubt the dosage of the MAOI was high enough to block the percentage of enzyme necessary to obtain an antidepressant response. It would be like taking no MAOI at all.
With Prozac, I would wait two weeks before initiating a MAOI. You probably won't attain sufficient MAO inhibition to produce a reaction until you have been at 40mg for 5 days or so. Starting Parnate at 10mg and titrating gradually will probably allow enough time to pass for the Prozac to clear your system before a reaction is allowed to occur.
All of this concern is, of course, about the induction of serotonin syndrome. These are some of the things to look out for:
Mental status changes
Confusion (51%)
Agitation (34%)
Hypomania (21%)
Anxiety (15%)
Coma (29%)Cardiovascular
Sinus tachycardia (36%)
Hypertension (35%)
Hypotension (15%)Gastrointestinal
Nausea (23%)
Diarrhea (8%)
Abdominal pain (4%)
Salivation (2%)Motor Abnormalities
Myoclonus (58%)
Hyperreflexia (52%)
Muscle rigidity (51%)
Restlessness (48%)
Tremor (43%)
Ataxia/incoordination (40%)
Shivering (26%)
Nystagmus (15%)
Seizures (12%)Other
Diaphoresis (45%)
Unreactive pupils (20%)
Tachypnea (26%)
Hyperpyrexia- Scott
poster:SLS
thread:621369
URL: http://www.dr-bob.org/babble/20060315/msgs/621944.html