Posted by ed_uk2010 on February 22, 2015, at 16:21:07
In reply to Re: can moclobemide be combined with desipramine or, posted by linkadge on February 20, 2015, at 21:05:29
>I think one of the metabolites of desipramine is more selective towards serotonin.
I read that too, but I'm unsure if it's produced in clinical relevant amounts.
>Nortriptyline might be safer (?) although I don't know for sure.
Nortriptyline also gives some 5-HT receptor blockadge. On the other hand, it's less selective for NET than desipramine.
Moclobemide is much less powerful than classical MAOIs with respect to elevating serotonin. As such, some people can even tolerate it in combo with SSRIs! Small clinical trials have looked at this combination. Although it did not produce the life-threatening serotonin toxicity reliably induced by the SSRI + classical MAOI combination, intolerable serotonergic side effects were frequent.
My opinion of the moclobemide + desipramine combination is that it's unlikely to produce serotonin syndrome. Any side effects are likely to be typical of each individual drug. As you say, the initial dose of desipramine should be very low because the combination is untested. The combination probably isn't a good idea in someone who hasn't tried and tolerated each drug separately.
poster:ed_uk2010
thread:1076938
URL: http://www.dr-bob.org/babble/20150129/msgs/1076992.html