Posted by SLS on June 12, 2005, at 7:27:39
In reply to Nardil + Effexor...I'm going for it!!!!, posted by ace on June 12, 2005, at 1:45:31
Don't do it.
I understand your plight and your desire to add an SRI to an MAOI.
If you do, you MUST have a comprehensive list of the signs and symptoms of serotonin syndrome so that you catch it as early as possible. Once it appears, I believe you will find it worsen dramatically without some sort of pharmacological intervention, so I hope you have your anti-serotonergics in place. Personally, I could not recommend which one(s) to choose. Cyproheptadine with a muscle-relaxing BZD like lorazepam or diazepam might be the best combination.
I once used a TEST DOSE of venlafaxine in combination with Parnate 120mg that I had taken at the time. The amount of venlafaxine was no more than 10-15mg. I suffered an extreme delirium. I didn't test my vital signs except for temperature, which was a little high.
In my opinion, Nardil is more likely to produce serotonin syndrome than is Parnate. I recommend that you employ a TEST DOSE first, and titrate up very, very gradually if you suffered no ill effects. You must remain vigilent in evaluating your condition. If SS symptoms begin to emerge, you MUST stop the venlafaxine immediately and begin taking your antidotes. Don't sit around hoping the symptoms will simply pass. By that time, it might be too late. Fatality is best avoided by remaining alive.
Read this:http://www.uspharmacist.com/oldformat.asp?url=newlook/files/feat/acf2fa6.htm
- Scott
poster:SLS
thread:511331
URL: http://www.dr-bob.org/babble/20050611/msgs/511376.html