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Re: MAOI + REMERON = Safe? For OCD?

Posted by King Vultan on April 20, 2004, at 7:42:58

In reply to MAOI + REMERON = Safe? For OCD?, posted by ace on April 20, 2004, at 2:03:08

It's at the end of the section "Combinations with other antidepressants."

My opinion is that Remeron is a safe drug to use with an MAOI, similar to how trazodone is. Trazodone also has a relatively powerful alpha-2 blockade, and while this does promote NE transmission (as well as 5-HT transmission--alpha-2 heteroreceptors are also located on serotonin neurons), this is a relatively weak effect, all things considered. Alpha-2 agents by themselves make pretty lousy antidepressants; although, they can be useful as augmenting agents.

Beyond that, it's clear that from the well established use of some tricyclic antidepresants with MAOIs, even ones with such significant effects on NE and 5-HT reuptake as amitriptyline, that the effects from Remeron's alpha-2 antagonism are likely fairly trivial in comparison. I think trazodone is even safer, as it blockades 5-HT1 receptors in addition to the 5-HT2 blockade it shares with Remeron, and to my way of thinking, trazodone would be an even better choice for treating serotonin syndrome. I think both drugs are perfectly safe to use with MAOIs, however.





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