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Re: Emsam switching to Effexor question NEED HELP!

Posted by undopaminergic on May 2, 2008, at 14:47:51

In reply to Emsam switching to Effexor question NEED HELP!, posted by satsumas on May 1, 2008, at 19:25:26

As a general rule, two weeks should pass after stopping an irreversible MAOI before starting a SSRI/SNRI. This is in order to allow time for replenishment of the MAO enzymes that were deactivated by the MAOI.

The main risk of starting a serotonergic drug too soon after a MAOI is the potentially life-threatening serotonin syndrome. Since it's the dose that makes the poison, it may be safe to start a serotonin reuptake inhibitor sooner at a low dose, but I have no data on that. If you decide to take the risk, you should first familiarise yourself with the signs and symptoms of serotonin toxicity, and keep cyproheptadine (Periactin) tablets available as an antidote (the relevant pharmacodynamic property is serotonin 5-HT2A-receptor blockade).


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