Posted by undopaminergic on May 29, 2008, at 23:14:21
In reply to Re: Parnate and Suboxone? » undopaminergic, posted by SLS on May 28, 2008, at 14:10:19
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> I was hoping that there would be more evidence of the safety of this combination. He really needs to try Nardil. He has tried everything except for the MAOIs. Much of what he experiences besides moderate depression is social anxiety.
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> Do you know of anyone having used this treatment who demonstrated its safety?
>No, but I know that the opioids currently known to interact with MAOIs all affect the reuptake of serotonin, and according to one expert on serotonin toxicity, Dr. Ken Gillman, "Morphine, codeine, oxycodone and buprenorphine are known not to be SRIs, and do not precipitate serotonin toxicity with MAOIs.".
One possible danger that may be unique to phenelzine and that doesn't apply to other MAOIs is the interactions of phenelzine's GABAergic metabolites with buprenorhpine (BUP). Co-administration of BUP and benzodiazepines has resulted in some deaths, but these were mostly in intravenous polysubstance abusers. If phenelzine is titrated with caution, this seems unlikely to be a serious danger.
Has this guy who "really needs to try Nardil" tried stimulants and memantine in combination with BUP? I'm wondering about this especially as there is theoretical potential for synergism between these drugs.
poster:undopaminergic
thread:831481
URL: http://www.dr-bob.org/babble/20080528/msgs/831998.html