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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by vince on February 27, 2001, at 23:56:09
Has anyone heard of combining very low dose paxil with very low dose parnate for treatment resistant depression? It sounds very risky because it could cause serotonin syndrome. My doctor told me that some psychopharmacologists are doing it, but that they have to know exactly what they are doing, and some require hospitolization until the dose and everything is stabilized. I wonder if this works in the same manner as 'death therapy' in the movie 'What About Bob'? But seriously does anyone know anything about this treatment.
Vince
Posted by kate9999 on February 28, 2001, at 0:33:41
In reply to Kamikaze pharmacology combining SSRI and MAOI ???, posted by vince on February 27, 2001, at 23:56:09
I haven't heard. I personally wouldn't. Just because given the number of meds and "cocktails" out there which aren't known to kill I can't see the need to try one that is.
> Has anyone heard of combining very low dose paxil with very low dose parnate for treatment resistant depression? It sounds very risky because it could cause serotonin syndrome. My doctor told me that some psychopharmacologists are doing it, but that they have to know exactly what they are doing, and some require hospitolization until the dose and everything is stabilized. I wonder if this works in the same manner as 'death therapy' in the movie 'What About Bob'? But seriously does anyone know anything about this treatment.
>
> Vince
Posted by SalArmy4me on February 28, 2001, at 9:39:32
In reply to Kamikaze pharmacology combining SSRI and MAOI ???, posted by vince on February 27, 2001, at 23:56:09
The only way to mix two serotonergic drugs would be to add an MAOI to a tricyclic (not a tricyclic to an MAOI). But even this is risky.
Posted by Eric on March 1, 2001, at 15:25:25
In reply to Kamikaze pharmacology combining SSRI and MAOI ???, posted by vince on February 27, 2001, at 23:56:09
> Has anyone heard of combining very low dose paxil with very low dose parnate for treatment resistant depression? It sounds very risky because it could cause serotonin syndrome. My doctor told me that some psychopharmacologists are doing it, but that they have to know exactly what they are doing, and some require hospitolization until the dose and everything is stabilized. I wonder if this works in the same manner as 'death therapy' in the movie 'What About Bob'? But seriously does anyone know anything about this treatment.
>
> VinceVince, DONT try to mix an MAOI with an SSRI. Its too high risk...it is indeed just about suicide. My Pdoc by the way told me I could possibly try this combo as well. I asked others about it, including my family doctor and he looked at me like I was insane.
MAOI plus SSRI equals death or serious complications in all likelihood.
Posted by JohnL on March 2, 2001, at 2:37:36
In reply to Kamikaze pharmacology combining SSRI and MAOI ???, posted by vince on February 27, 2001, at 23:56:09
Combining SSRIs and MAOIs has been done in the past. It must be done very cautiously. Most doctors today probably would not do it.I would not do it either because in my frame of thinking it simply means the chemical imbalance responsible for the symptoms has not yet been targeted.
For so called treatment resistant depression, I strongly favor antipsychotic and/or stimulant additions to your favorite antidepressant. Even if your favorite antidepressant isn't anything spectacular, either an antipsychotic or stimulant or both can turn it into a miracle. And by far way safer than MAOI.
Some big guns combinations include: Effexor+Remeron. Prozac+Zyprexa. I favor that latter, though the former has worked well for others here. And it's no secret I favor two foreign medications, Adrafinil and Amisulpride. I would not even think about MAOIs until at least three antipsychotics, three stimulants, and three antidepressants had been tried. Preferably combinations of two or three of them.
John
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