Posted by schleprock on August 26, 2012, at 22:02:32
In reply to Re: Lou's request-krduhbillehty » Lou Pilder, posted by SLS on August 26, 2012, at 11:09:32
> I like this one. Although the article is old, it probably includes more cases than any other study you will find. It was written at a time before SSRIs became available, and MAOIs and tricyclics were about the only antidepressants available. Doctors at the time were much more informed and comfortable with their use than today. Combining MAOIs and tricyclics were not strictly forbidden. My first introduction to this treatment modality occurred in 1983. It was then that my doctors at Columbia treated me with a combination of Nardil and amitriptyline. I have been prescribed tricyclics with MAOIs on and off for the last 30 years without incident. Recommendations for this treatment were made to me by doctors at Columbia, NYU, NIMH, Beth Israel, Harvard, and Princeton.
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> - Scott
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> http://www.ncbi.nlm.nih.gov/pubmed/942286
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> "Arch Gen Psychiatry. 1976 Jul;33(7):828-30.
> Combining tricyclic and monoamine oxidase inhibitor antidepressants.
> Spiker DG, Pugh DD.
> Abstract
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> The charts of 150 inpatients and 51 outpatients treated with a monoamine oxidase inhibitor (MAOI)-tricyclic antidepressant combination were reviewed. The incidence and severity of side effects among the patients on the combined regimen were essentially the same as those seen in the control groups. There were no deaths or strokes resulting from use of this regimen. The most frequent troublesome side effect was orthostatic hypotension. We conclude that the use of a MAOI-tricyclic combination in oral therapeutic doses is safe. However, the efficacy of this combination has not yet been proved, and it may be particularly toxic if taken in an overdose."Here's a more recent (2007) article that supports Nortriptyline and MAOI compatability:
http://onlinelibrary.wiley.com/doi/10.1038/sj.bjp.0707253/full
(From the conclusion)
"Nortriptyline has superior pharmacological properties to all other TCAs as a psychotropic; it is potent as an NRI and has a wide margin between desired effects, side effects and toxicity. It is safe to combine it with either MAOIs (including moclobemide) or selected SSRIs (sertraline and possibly citalopram). This is an advantage when treating refractory patients who may require combination antidepressant treatment: neither changes from one drug to another, nor additions to initiate combined treatments with either an MAOI or an SSRI, require drug washout times, as they do for most SSRIs. All SSRIs are strongly contra-indicated with all MAOIs."
poster:schleprock
thread:1024162
URL: http://www.dr-bob.org/babble/20120818/msgs/1024275.html