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Re: Low dose dexedrine contra. with nardil? » jonh kimble

Posted by CamW on September 12, 2005, at 18:38:36

In reply to Low dose dexedrine contra. with nardil?, posted by jonh kimble on September 12, 2005, at 15:36:16

John - No, this is one of those instances where the drug/drug interaction is real. Several deaths have been documented in the literature as a result of Nardil™ (phenelzine) and Dexedrine™ (dextroamphetamine) have been taken concomittantly.

CNS stimulants (centrally-acting sympathomimetic agents), like amphetamines or even decongestants when mixed with MAOIs (monoamine oxidase inhibitors like phenelzine) can result in severe hypertensive reactions (sudden dramatic increases in blood pressure) ). Death has occurred in some reported cases.

The mechanism of this interaction is a synergistic sympathomimetic effect due to the Nardil™ enhancing norepinephrine storage in adrenergic neurons by decreasing the rate of metabolism of the norepinephrine; as well as an increase in the neuron's release of the norepinephrine or (more likely) a decreased reuptake of norepinephrine (and other catecholamines) due to the Dexedrine's™ central sympathomimetic activity.

Also, the choice of using the long-acting formulation of dextroamphetamine (ie. Dexedrine Spansules) could be a fatal one, as it is harder to eliminate from the body due to the slower absorption resulting in extended action in the brain. As a result, if a hypertensive crisis resulted from combined ingestion of Nardil™ and Dexedrine Spansules™ would be much harder to treat.

I hope that this is of some help. - Cam


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