Posted by Sunnely on August 25, 2000, at 19:58:27
In reply to Re: Reboxetine/SSRI combos/SUNNELY, posted by SLS on August 25, 2000, at 7:36:04
> Substituting desipramine (Norpramin) for reboxetine might be an alternative. Like reboxetine, desipramine is a potent and selective NE reuptake inhibitor. Perhaps Sunnely can offer an evaluation of Serzone-desipramine interactions. I don't think they significantly interfere with each other's metabolisms.
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> - ScottHi Scott,
Reboxetine (Edronax, Vestra) and desipramine (Norpramin) both act as norepinephrine reuptake inhibitor. Reboxetine is "cleaner" than desipramine, however. Desipramine, apart from inhibiting norepinephrine uptake, carries the extra baggage of blocking the muscarinic cholinergic receptors and alpha1-adrenergic receptors, which can result in unwanted side effects (e.g., blurred vision and drop in blood pressure, respectively).
Desipramine modestly increase the blood level of nefazodone under relevant steady-state dosing conditions. Nefazodone has been shown (in vitro) to be a potent inhibitor of the liver enzyme CYP3A4 and a weak inhibitor of CYP2D6. Desipramine is a model substrate for the liver enzyme CYP2D6. Nefazodone has been shown in an in vivo study to be at least 40 times less potent than fluoxetine (Prozac) in inhibiting the action of CYP2D6. The combined use of nefazodone (300 mg/day at steady state) and desipramine led to modest increase in desipramine blood level. This study also indicates that triazolodione and mCPP (meta-chlorophenylpiperazine), the principal metabolites of nefazodone, do not inhibit CYP2D6.
Final answer: No significant pharmacokinetic drug-drug interactions between nefazodone and desipramine.
poster:Sunnely
thread:43574
URL: http://www.dr-bob.org/babble/20000822/msgs/43725.html