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Dr. Bob is Robert Hsiung, MD,
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Posted by tygereyes on September 3, 2005, at 11:55:12
Does 100 mg of Desipramine and 100 mg of Zoloft put me at risk for serotonin syndrome?
Or is this restlessness and excitability because I (theoretically) have Bipolar II Disorder?
Posted by linkadge on September 3, 2005, at 12:04:42
In reply to Serotonin Syndrome, posted by tygereyes on September 3, 2005, at 11:55:12
The desipramine would not contribute to a sertonin syndrome since it is a norepinephrine reputake inhibitor with little/no affinity for serotonin uptake.
Some people experience serotonin syndrome on an SSRI alone, so it is a possability. You would need to see if you fit more than one of the symptoms.
Desipramine is fairly stimulating I would certainly consider the combination a "stimulating" combination.
If you are restless, I would decrease the desipramine, if it is more of a psychic agitation, then I would decrease the zoloft.
You need to have a clear idea of weather you think this is like you, or if it is drug induced.
Linkadge
Posted by Jedi on September 4, 2005, at 4:03:21
In reply to Serotonin Syndrome, posted by tygereyes on September 3, 2005, at 11:55:12
> Does 100 mg of Desipramine and 100 mg of Zoloft put me at risk for serotonin syndrome?
>
> Or is this restlessness and excitability because I (theoretically) have Bipolar II Disorder?
Hey Tygereyes,
Sertraline can affect the level of desipramine in the blood. The half-life of desipramine is affected by sertraline inhibiting the enzyme CYP2D6 from metabolizing desipramine. TCAs can be fatal in overdose, so be careful with this combination. I would suggest getting a desipramine blood level to be sure. A higher than expected level of desipramine in the blood would explain your symptoms.
Good Luck,
JediThe effect of sertraline on the pharmacokinetics of desipramine and imipramine.
Link:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9284850&query_hl=1
Kurtz DL, Bergstrom RF, Goldberg MJ, Cerimele BJ.“OBJECTIVE: To examine the pharmacokinetic interaction between the selective serotonin reuptake inhibitor sertraline and the tricyclic antidepressants desipramine or imipramine in 12 healthy male subjects. … CONCLUSIONS: This pharmacokinetic interaction is likely the result of an inhibition of CYP2D6 tricyclic metabolism by sertraline. When a tricyclic antidepressant, such as desipramine or imipramine, is coadministered with sertraline, lower dosages of the tricyclic agents may be necessary to prevent elevated tricyclic levels.”
Posted by blueberry on September 4, 2005, at 7:37:36
In reply to Serotonin Syndrome, posted by tygereyes on September 3, 2005, at 11:55:12
Serotonin syndrome on your meds is not likely because desipramine doesn't affect serotonin much. It is remotely possible, but not likely.
The norepinephrine reuptake inhibition of desipramine can be quite stimulating. It also has some action on dopamine D2 receptors. Zoloft has some mild dopamine reuptake inhibition to it. Put the two meds together and over stimulation would not be a surprise, with a boost in both norepinephrine and dopamine. Zoloft can interfere with the breakdown of desipramine in your system, so a build up of desipramine could be a factor as well. Having a blood test for desipramine levels would be helpful. But without a blood test, you could just reduce the amount of desipramine you are taking to a more comfortable level. I tried desipramine with prozac and found that even miniscule amounts of desipramine were way too stimulating for me.
Posted by linkadge on September 4, 2005, at 8:02:50
In reply to Re: Serotonin Syndrome » tygereyes, posted by Jedi on September 4, 2005, at 4:03:21
Good thinking.
Posted by Jedi on September 4, 2005, at 22:23:21
In reply to Thats why they call him a jedi.. » Jedi, posted by linkadge on September 4, 2005, at 8:02:50
This is the end of the thread.
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