It is a very dangerous combo due to maoi's interactions with stimulants.
It's not
that risky, according to the first reference in my above post:
There is now a lot of accumulated experience of the concurrent administration of MAOIs and amphetamine for therapeutic purposes in depression. It is safe when done carefully. Early concerns about frequent hypertension have not materialized and recent clinical reviews indicate judicious use is safe [354, 355]. Releasers (indirectly acting sympatho-mimetics ISAs), pg. 34
There is enough evidence to question the claim that any noradrenaline or serotonin booster is taboo with an MAOI, i.e., see my thread:
Combining MDx with harmalas
There is promising feedback about combining kanna with harmalas. Kanna is a serotonin releaser and reuptake inhibitor. I've tried the combo and it was the only time I got an effect from kanna. See that thread for the relevant info. I also tried ¼ of a Zoloft with harmine and it was the only time I got an effect from Zoloft.
In mental depression, new approaches could also combine both MAO inhibition and serotonin reuptake inhibition to increase extracellular 5-HT concentration at the synapses.
Structural Aspects of Monoamine Oxidase and its Reversible Inhibition. Johan Wouters. 1998. Current Medicinal Chemistry, vol. 5, #2, 136-162 Conclusions and Perspectives, p. 159
There were actually three trials where serotonergic antidepressants were combined with MAOIs. Summaries from
Grok:
Joffe, R. T., Bakish, D. 1994. Combined SSRI-moclobemide treatment of psychiatric illness. The Journal of clinical psychiatry, 55(1), 24–25.
Study Details: This 5-week trial combined moclobemide with the selective serotonin reuptake inhibitors (SSRIs) sertraline or fluvoxamine in 11 patients.
Results: Eight out of 11 patients responded, and the combination was reportedly well-tolerated.
Adverse Events: Some reports of insomnia were noted, but no other significant adverse events were highlighted.
Hawley, C. J., Quick, S. J., Ratnam, S., Pattinson, H. A., McPhee, S. 1996. Safety and tolerability of combined treatment with moclobemide and SSRIs: a systematic study of 50 patients. International clinical psychopharmacology, 11(3), 187–191. DOI: 10.1097/00004850-199609000-00005
Study Details: This 6-week trial involved 50 TRD patients treated with moclobemide combined with the SSRIs paroxetine or fluoxetine.
Results: The combination appeared efficacious for treating depression.
Adverse Events: There was a high rate of adverse events, many of which were severe, though specific events were not detailed in the summary.
Amsterdam, J. D., García-España, F., Rosenzweig, M. 1997. Clomipramine augmentation in treatment-resistant depression. Depression and anxiety, 5(2), 84–90.
Study Details: This 6-week trial involved 27 patients with TRD. It compared:
▪ MAOI (phenelzine, tranylcypromine, or isocarboxazid) + clomipramine (N=9),
▪ Fluoxetine + clomipramine (N=11),
▪ MAOI + conventional TCA (desipramine, amitriptyline, imipramine, or nortriptyline) (N=7).
Results: Response rates were low: 2 of 9 responded to MAOI + clomipramine, 4 of 11 to fluoxetine + clomipramine, and 3 of 7 to MAOI + conventional TCA.
Adverse Events: The MAOI + clomipramine combination was associated with more adverse events than the other groups, including several cases of serotonin syndrome.