Posted by JaclinHyde on March 31, 2006, at 14:31:43
In reply to Re: Maybe Parnate again?, posted by Maxime on March 31, 2006, at 9:36:01
Whoa...it's the Remeron that you should be the most worried about. Here is what medscape has to say...
"Patient Regimen
REMERON ORAL
PARNATE ORALInteractions
Contraindicated Drug Combination
TRI;TETRACYCLIC COMPOUNDS/MAOIS
Remeron Oral and Parnate Oral may interact based on the potential interaction between TRI;TETRACYCLIC COMPOUNDS and MAOIS.Tri; Tetracyclic Compounds/MAOI'S
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
MONOGRAPH TITLE: Tri; Tetracyclic Compounds/MAOI'S
SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.
MECHANISM OF ACTION: Two possible mechanisms have been proposed for this interaction. MAO inhibitors may enhance the effects of the tricyclic antidepressants indirectly through inhibition of microsomal enzymes. Tricyclic antidepressants may sensitize adrenergic receptors to amines which then accumulate extraneuronally as a result of MAO inhibition.
CLINICAL EFFECTS: Increased effects of both drugs. Severe reactions including hyperpyrexia, convulsions, excitability, muscular rigidity, fluctuations in blood pressure, convulsions, grand mal seizures, coma, and death have been reported.
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The concurrent use of tricyclic antidepressants and MAO inhibitors is contraindicated by the manufacturers of tricyclic antidepressants and tranylcypromine.
The manufacturers of tricyclic antidepressants and mirtazapine recommend at least 14 days between switching therapies. The manufacturer of tranylcypromine recommends a medication-free interval of at least a week when initiating tranylcypromine in patients who have previously received a tricyclic antidepressant, then initiating tranylcypromine at a reduced dosage of 50% for one week.
The manufacturer of phenelzine states that if phenelzine is used concurrently with or within 10 days of another antidepressant, the patient should be cautioned regarding the possibility of an adverse drug interaction.
DISCUSSION: It should be noted that if this interaction occurs, the consequences will be immediate and severe. Effects may continue to be seen for several days after discontinuing the MAOI. Similarity between cyclobenzaprine and TCA's warrants consideration of TCA interactions for cyclobenzaprine. Mirtazapine, a tetracyclic antidepressant, should also be considered for this interaction. Furazolidone and linezolid are known to inhibit MAO."
JH
poster:JaclinHyde
thread:626994
URL: http://www.dr-bob.org/babble/20060329/msgs/627140.html