In addition to BT's excellent summary, just wanted to add a few things. I didn't catch the show you mentioned, but I suspect they were referring to MAOI's. Now there is hardly anyone taking MAOI's anymore (they are fantastic at treating depression and anxiety, but too risky with all the food and drug interactions) so it is unlikely anyone will actually combine the two. Moclobemide (a reversible inhibitor of monoamine oxidase) is safer than a MAOI, but theoretically it could cause SS, and is definitely contra-indicated with amphetamines.
The dancesafe slideshow talks about SSRI's blocking the re-uptake transporter, meaning MDxx can't latch on, and is therefore often ineffective. Most of the other A.D's on the market have some re-uptake inhibition properties, including TCA's, nefazodone, and venlafaxine (NOTE: before people start posting to tell me these drugs are not SSRI's, note that I said "properties").
Therefore, it is possible that MDxx will be ineffective for people on these A.D's too. If the MDxx, can't work, it can't cause SS. But then there are those people who say they do still roll on SSRI's and other A.D's, so whether they are at higher risk for SS is not clear to me.
There is another risk from combining A.D's with MDxx. Some A.D's inc. inhibit (reduce the action) of one or both of the enzymes responsible for breaking down MDxx in your liver. This means it will take longer for your body to metabolise the MDxx, so levels can accumulate, causing toxicity. MDxx is mainly metabolised by CYP2D6, and to a lesser extent CYP3A4.
ANTIDEPRESSANTS THAT INHIBIT CYP2D6:
* SSRI's, nefazodone, venlafaxine, clomipramine and possibly other TCA's, moclobemide
ANTIDEPRESSANT'S THAT INHIBIT CYP3A4
* SSRI's, nefazodone, ?others
You will notice that SSRI's and nefazodone appear on both lists, meaning combining with MDxx could result in decreased e metabolism=levels of e increase in your body=problems, including SS. Having said that, there are plenty of BL'ers who will put their hands up to having taken these sort of combo's...
There are different levels of SS, and the symptoms of mild SS are indeed similar to that of MDxx intoxication. Severe SS is of course a medical emergency.
(I hope this makes sense - it is the 2nd attempt after my pc died, and I am starting to confuse myself
)
[This message has been edited by babydoc_vic (edited 01 December 2001).]