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Re: Parnate WITH Moclobemide ? What do you think?

Posted by SLS on November 12, 2005, at 8:39:54

In reply to Parnate WITH Moclobemide ? What do you think?, posted by Muad' Dib on November 12, 2005, at 7:57:49

> What do you think of combining Parnate with Moclobemide (both low doses - Parnate 20mg, Moclobemide 75-150mg). Via MAO inhibition - Parnate mainly increases DA and NA, Moclobemide SA and NE.
>
> What do you think?


How do you know that Parnate doesn't increase serotonin by an amount comparable to dopamine and norepinephrine?

What has been your experience with each of these drugs?

As far as the combining of the two drugs, I have never followed anyone who has tried it. It sounds very interesting, though.

Were you thinking of beginning both drugs at the same time? If not, I really don't know which order is safest. I can guess though. I think you should try moclobemide first and establish a dosage of 300mg first. Then add in the Parnate at a dosage of 30mg. I am basing this guess on the tradition of establishing a tricyclic first before adding Parnate. Of course, I might be guessing wrong. However, I have combined Parnate with TCA quite a few times, and for me, the order made no difference.

I guess the two events that are most dangerous are:

1. Hypertensive event

2. Serotonin Syndrome


I think you should be prepared with a supply of antidotes for both possible sequalae.

1. nifedipine or phentolamine for hypertensive crisis

2. cyproheptadine for serotonin syndrome


Become familiar with the symptoms of both events.

1. http://home.intekom.com/pharm/smith_kb/parnate.html

2. http://www.uspharmacist.com/oldformat.asp?url=newlook/files/feat/acf2fa6.htm


- Scott

 

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