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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Edwin Ransom on August 7, 2006, at 20:17:29
Does anyone know what kind of wash-out period is appropriate when switching from inositol to EMSAM?
I'm inclined to assume that a two-week buffer is needed because the effects of inositol can be similar to those of an SSRI (1) and a two-week period is prescribed for anyone switching to EMSAM from an SSRI.
(1) (ref: http://www.ncbi.nlm.nih.goventrezquery.fcgicmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11386498 )
Posted by Phillipa on August 7, 2006, at 22:15:11
In reply to EMSAM and Inositol, posted by Edwin Ransom on August 7, 2006, at 20:17:29
Some say a week for any but prozac which requires five weeks. Love Phillipa
Posted by SLS on August 8, 2006, at 6:24:10
In reply to EMSAM and Inositol, posted by Edwin Ransom on August 7, 2006, at 20:17:29
I couldn't get your link to work. Otherwise, I know of no reason why you could not take inositol and a MAOI like Emsam at the same time. It should be safe.
- Scott
Posted by Jost on August 8, 2006, at 12:46:48
In reply to EMSAM and Inositol, posted by Edwin Ransom on August 7, 2006, at 20:17:29
Posted by Edwin Ransom on August 8, 2006, at 12:46:54
In reply to Re: EMSAM and Inositol, posted by SLS on August 8, 2006, at 6:24:10
Sorry about the link:
This is just the study in which the Israelis discovered that inositol had SSRI-like effects.
My logic follows this pattern:
1.) Serotonin syndrome will happen if you have too much serotonin in your brain.
2.) SSRIs increase the amount of serotonin in your brain.
3.) Inositol effects behavior the way an SSRI would, so it increases the amount of serotonin in your brain
4.) SSRIs combined with MAOIs cause you to have too much serotonin in your brain.
5.) Inositol combined with a MAOI may cause serotonin syndrome.
The weak step is 3.), I am wondering if inositol might have a completely different mechanism of action from the SSRIs. I know that people have reasoned from the low side-effect profile of inositol to the conclusion that inositol is very selective and therefore less of a risk. But this doesn't seem conclusive: it may be selective, but still work on the subdomain of serotonin receptors that cause the syndrome.
I just don't know anything about neurophysiology.
It would be great if inositol and Emsam could be safely combined. It sounds like a lot of people who take Emsam for depression still have anxiety problems.
Posted by Jost on August 8, 2006, at 21:22:30
In reply to Re: EMSAM and Inositol, posted by Edwin Ransom on August 8, 2006, at 12:46:54
The study compares inositol with luvox, but that doesn't mean that there's any similarity between the compounds in terms of exact mechanism of effect. The chemical and biological (or neurobiological) mechanisms of inositol aren't really dealt with in the abstract. There are many different drugs that reduce anxiety.
About all the study does is show that inositol helps with panic disorder, and that it has fewer side effects of a certain kind that a common SSRI. SSRIs are probably the most commonly prescribed ADs, which may be why they used one. I presume luvox is also used for panic disorder.
I don't know enough about inositol to say definitively that it doesn't affect serotonin, but there's nothing in the study to suggest that it does.
Jost
Posted by laima on August 12, 2006, at 7:54:53
In reply to Re: EMSAM and Inositol, posted by Jost on August 8, 2006, at 21:22:30
I'm interested in this too- but do I understand correctly then that the safety of this combo is uncertain?
Posted by Jost on August 12, 2006, at 11:43:37
In reply to Re: EMSAM and Inositol, posted by laima on August 12, 2006, at 7:54:53
I don't think so, Laima. The inference that Edwin Ransom made wasn't a proper inference from the article.
If they had picked some other AD to compare to inositol, Edwin R might not have focussed on the serotonin element of the equation.
There's no particular reason to think that, if inositol does have anti-anxiety effects, it's because of a serotonin-raising property. But of course, it is possible.
Possible means that on my own knowledge, I couldn't rule it out, because I just don't know. Doesn't mean that there's any reason to have made the association.
However, since it's come to our attention, if you can't find out definitively, you could use caution at first. I would ask my Pdoc-- just to be sure. But if he doesn't know, I would experiment carefully after I'd been on my target dose of emsam for a while.
Jost
Posted by laima on August 12, 2006, at 16:47:34
In reply to Re: EMSAM and Inositol » laima, posted by Jost on August 12, 2006, at 11:43:37
Thank you- too bad my doctor feels most supplements, including vitamins, are a useless waste of money- that's one thing I disagree with him about. I suppose the thing to do then might be to open up the capsule and try a teeny amount and see what happens--but maybe later.
> I don't think so, Laima. The inference that Edwin Ransom made wasn't a proper inference from the article.
>
> If they had picked some other AD to compare to inositol, Edwin R might not have focussed on the serotonin element of the equation.
>
> There's no particular reason to think that, if inositol does have anti-anxiety effects, it's because of a serotonin-raising property. But of course, it is possible.
>
> Possible means that on my own knowledge, I couldn't rule it out, because I just don't know. Doesn't mean that there's any reason to have made the association.
>
> However, since it's come to our attention, if you can't find out definitively, you could use caution at first. I would ask my Pdoc-- just to be sure. But if he doesn't know, I would experiment carefully after I'd been on my target dose of emsam for a while.
>
> Jost
>
>
This is the end of the thread.
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