Psycho-Babble Medication | about biological treatments | Framed
This thread | Show all | Post follow-up | Start new thread | List of forums | Search | FAQ

Re: Fluoxetine + TCA = major toxcity? » Crotale

Posted by Down on the Upside on August 9, 2008, at 3:00:43

In reply to Re: Fluoxetine + TCA = major toxcity? » Down on the Upside, posted by Crotale on August 8, 2008, at 3:35:43

Thanks for replying Crotale. Well I tried a few 20mg doses of fluoxetine and the depression got horrendously worse than baseline. Dunno if my body has some weird paradoxical to too much serotonin because I also feel this horrible when I take the amitryptiline daily instead of at night. Thankully it's much better after a week or so. That's one experiment I'm not likely to try again.

> Yes, TCA + fluoxetine is a combo that should only be used with extreme caution. The way to do it, if there isn't a safer alternative, is reduce SSRI dose, then titrate and monitor TCA level carefully. Talk to your doctor for more info, and don't do this except under your doc's supervision!!!
>
> TCAs have a very narrow therapeutic index - that is, the toxic dose isn't much higher than the effective dose. Besides the potential for drug interactions, some people are deficient in one of the enzymes involved in TCA metabolism due to a mutation in CYP2D6 (possibly other cytochrome P450 genes, but inhibition of 2D6 is definitely known to cause elevated TCA levels).
>
> I had a bad reaction to desipramine, and it turned out my serum level was elevated to several times the expected level. I still am not sure whether it was me or an unexpected drug interaction. (I wasn't taking an SSRI or any other drug known to raise tricyclic levels.) I had what they think was a seizure but the cardiotoxic effects of TCAs can be fatal in overdose.
>
> Be careful!
>
> -Crotale


Share
Tweet  

Thread

 

Post a new follow-up

Your message only Include above post


[845112]

Notify the administrators

They will then review this post with the posting guidelines in mind.

To contact them about something other than this post, please use this form instead.

 

Start a new thread

 
Google
dr-bob.org www
Search options and examples
[amazon] for
in

This thread | Show all | Post follow-up | Start new thread | FAQ
Psycho-Babble Medication | Framed

poster:Down on the Upside thread:844000
URL: http://www.dr-bob.org/babble/20080805/msgs/845112.html