Posted by desolationrower on November 22, 2008, at 16:00:49
In reply to Re: tranylcypromine + mirtazapine? » CaptainAmerica1967, posted by jedi on November 22, 2008, at 12:01:02
well phentolamine is mostly used because its an alpha1 blocker. alpha 2 blockade increases blood pressuer. alpha2 is the adrenoceptor autoreceptor that controls release.
As for serotonin syndrome, I'm not sure that is a risk. It is a 5ht2 antagonist, which blocks ss. I would try to get my hands on the full text of this review:
Hum Psychopharmacol. 2006 Mar;21(2):117-25.Click here to read Links
A systematic review of the serotonergic effects of mirtazapine in humans: implications for its dual action status.
Gillman PK.A systematic review of published work concerning mirtazapine was undertaken to assess possible evidence of serotonergic effects or serotonin toxicity (ST) in humans, because drug toxicity and interaction data from human over-doses is an useful source of information about the nature and potency of drug effects. There is a paucity of evidence for mirtazapine having effects on any indicator of serotonin elevation, which leads to an emphasis on ST as an important line of evidence. Mirtazapine is compared with its analogue mianserin, and other serotonergic drugs. Although mirtazapine is referred to as a dual-action 'noradrenergic and specific serotonergic drug' (NaSSA) little evidence to support that idea exists, except from initial microdialysis studies in animals showing small effects; those have not subsequently been replicated or substantiated by independent researchers. Also, new data indicate its affinity for Alpha 2 adrenoceptors is not different to mianserin. It appears to exhibit no serotonergic symptoms or toxicity in over-dose by itself, nor is there evidence that it precipitates ST in combination with monoamine oxidase inhibitors, as would be expected if it raises intra-synaptic serotonin levels. Mirtazapine has no demonstrable serotonergic effects in humans and there is insufficient evidence to designate it as a dual-action drug.
-d/r
poster:desolationrower
thread:864556
URL: http://www.dr-bob.org/babble/20081114/msgs/864703.html