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Re: Other combinations

Posted by Elizabeth on March 28, 1999, at 2:13:48

In reply to Re: Other combinations, posted by Nick on March 24, 1999, at 15:10:40

> Interesting - the main metabolite of lofepramine is desipramine; desipramine is no longer in use here because of cardiotoxicity, yet lofepramine is pretty safe in overdose. Go figure.

I didn't know that lofepramine is metabolized to desipramine! Go figure, indeed. (Desipramine is the most used of the tricyclics here because it has fewer side effects than the other ones we have.)

>Other 'heroic' combinations include nefazadone + venlafaxine (I think Steven Stahl uses this one) + the old favourites of TCA + MAOI (ouch). Some evidence for buspirone + SSRIs & pindolol + SSRIs. Its a complicated world.

Yeah, I've heard of some strange ones - SSRI + pretty much anything except an MAOI, or even two SSRIs together, TCA + MAOI (rumor hath it the tricyclic may provide some resistance to MAOI-induced hypertension), etc. I don't hear of pindolol being used so much; buspirone, valproate, olanzapine and risperidone, and old standbys like lithium seem to be the favored augmentation drugs. Also, bupropion gets added to just about anything including MAOIs.

Ever used reboxetine in combinations? I'm surprised I don't hear more about that.




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