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Dr. Bob is Robert Hsiung, MD,
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Posted by JohnL on August 14, 1999, at 13:16:54
Hi all. In previous Selegiline posts there were warnings about combining this drug with SSRIs. I stumbled onto a few studies where it was combined with Prozac and Celexa, with no adverse reactions. Side effects were no different than monotherapy. I realize there is always the risk of serotonin syndrome when combining various drugs, but I am curious as to why the Selegiline threads advised not combining with SSRIs. I would suspect there would be real danger at a high dose, but, any comments? Thanks. JohnL.
Posted by Elizabeth on August 14, 1999, at 22:00:44
In reply to Selegiline + SSRI?, posted by JohnL on August 14, 1999, at 13:16:54
> Hi all. In previous Selegiline posts there were warnings about combining this drug with SSRIs. I stumbled onto a few studies where it was combined with Prozac and Celexa, with no adverse reactions. Side effects were no different than monotherapy. I realize there is always the risk of serotonin syndrome when combining various drugs, but I am curious as to why the Selegiline threads advised not combining with SSRIs. I would suspect there would be real danger at a high dose, but, any comments? Thanks. JohnL.
It's a pretty rare interaction, and the only studies I'm aware of were relatively small. This may account for why there didn't seem to be any evidence of an interaction in those studies. However, because the central serotonin syndrome is so dangerous (i.e., it can kill you, and there really isn't a reliable treatment), it may not be worthwhile to mess with the combo. You have to weigh the possible risks and benefits for yourself, of course.
I don't know that low-dose selegiline would be all that useful in depression, anyway. It might work for ADHD-type symptoms, though.
[Note that there is the potential for other drug-drug interactions with selegiline (e.g., with Demerol).]
This is the end of the thread.
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