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Harm Reduction SSRI & MAOI together?

M

Mighty-oak

Bluelighter
Joined
Mar 1, 2016
Messages
290
My Dr seems to think that an MAOI and an SSRI are ok to use together, yet everything I have read online says not to mix them, in fact it says to come off the SSRI and give 7 days before starting an MAOI......Anybody heard of using an MAOI with an SSRI?
 
Combining a SSRI and a MAOI will result in Serotonin Syndrom and can kill you.
Maybe an ultra small dose of both won't kill you, but imo it's not worth the risks. Your doctor seems to be an idiot.
 
Contrary to common belief, a MAOI + stim/reuptake inhibitor combo does not automatically equal instant death.

If it did, several drugs - including prescription drugs - would effectively be suicide pills:
Selegiline? Irreversible MAO-B inhibitor, converted to L-Methamphetamine in the body
Tranylcypromine? Cyclized form of amphetamine that is simultaneously an irreversible MAOI and a mild noradrenaline-dopamine-releasing agent
Alpha-Methyl-Tryptamine? Triple releasing agent and MAOI. Used as an antidepressant in the Soviet union, but was eventually phased out due to abuse potential and safety concerns (still, keep in mind that it was apparently possible to use this serotonin-releasing(!) MAO-inhibiting drug recreationally up to a certain point without automatically suffering serotonin syndrome)

No, I am by no means telling you to go out and start doing Molly while on Phenelzine, and it is commendable that you actually doublechecked your prescriptions for dangerous interactions, but it is very much possible to use a carefully dosed MAOI without having your head explode everytime you eat a slice of cheese or take a carefully dosed SSRI. Naturally you should check your blood pressure though, and watch out for any signs of serotonin syndrome or mania.
 
Thanks :)

The MAOI he wants to try me on is called Moclobemide.....Copied and pasted from Wiki 'Moclobemide is a reversible inhibitor of monoamine oxidase A drug primarily used to treat depression and social anxiety'

The SSRI I am on is called Citalopram, also known as Celexa, I take 40mg a day and been on this dose for 15 years. The Dr said MAOI's work well for agoraphobia which I have and and am also on Klonopin and Valium, been on these for years and years, trying to even lower the dose a tiny amount on Klonopin makes my anxiety go so high. I have tried Gabapentin and Pregabalin with no real joys so hoping an MAOI will help, only thing that worries me is the reports of MAOI's on the net saying how dangerous they are.....But this one is a reversible one so wonder if it is safer?
 
The fact that 'there is a chance you might not die' does not mean this combination makes sense. the pros outweigh the cons tenfolds. You only have one brain, take care of yourself. Apparently your doctor missed something in school.

http://patient.info/doctor/selective-serotonin-reuptake-inhibitors

"With monoamine oxidase inhibitors (MAOIs)/moclobemide: serious toxicity risk. If changing from an SSRI, an MAOI or moclobemide should not be started until: 5 weeks after stopping fluoxetine; 2 weeks after stopping sertraline; 1 week after other SSRIs. Also, more than 5 weeks should elapse if on high doses or chronic use of fluoxetine. If changing from an MAOI, do not start SSRIs until 2 weeks after stopping an MAOI"

This is a good read. This article is not the work of a medical scholar, but it is the work of someone who is part of the patient.info message boards and has gotten many users permission to use their experiences on this matter and their threads to give an insight based on not just the research he's done, but more importantly the expereinces of other people.

Im not trying to discourage you you will do what you want to do. At the same time, though, don't say no one warned you of this nasty combination.
 
Mighty-oak said:
Thanks :)

The MAOI he wants to try me on is called Moclobemide.....Copied and pasted from Wiki 'Moclobemide is a reversible inhibitor of monoamine oxidase A drug primarily used to treat depression and social anxiety'

The SSRI I am on is called Citalopram, also known as Celexa, I take 40mg a day and been on this dose for 15 years. The Dr said MAOI's work well for agoraphobia which I have and and am also on Klonopin and Valium, been on these for years and years, trying to even lower the dose a tiny amount on Klonopin makes my anxiety go so high. I have tried Gabapentin and Pregabalin with no real joys so hoping an MAOI will help, only thing that worries me is the reports of MAOI's on the net saying how dangerous they are.....But this one is a reversible one so wonder if it is safer?
Click to expand...

You've been doing your own research that is great. In general, as you probably are aware by now, majority of MAOIs are irreversable, there is no agent that can stop the damage of a bad coctail of drugs interacting with an maoi, only time will reverse the effects of the inhibitor, whatever the half life of the specific drug is. As for the reversible one you just stated maybe you can specifically request it to see if the combo is safe with a drug that is reversable if things go sour? Not sureabout requesting a drug, though. Good luck man
 
Thanks greatly for the helpful replies.

I wonder if Moclobemide will help with agoraphobia as I am housebound, although it seems much of my anxiety/agoraphobia is due to very long term benzo use as it seems long term use actually makes anxiety worse?
 
Yep....long time benzo use makes it worse.....I had to deal with anxiety and panic attacks for far too long in my life...and was addicted to benzos for many years....tapering the benzos and behavorial therapy cured me.

I'm way less anxious since i dont take benzos anymore.

And I suggest to stay on the safer side and definitely dont combine maoi with ssri!
 
It seems to be popping up more and more on the net about long term useage of benzos making anxiety even worse than originally prescribed for. So glad you are feeling better since stopping them zirbeldude2 :)

I wonder if Moclobemide will be better for anxiety than Celexa? Stopping Celexa is scary as tried before some years ago, got these electric shock things in my head, hearing became really enhanced as did vision, was not nice.
 
Did you taper the citalopram? Because 40mg is a highish dose and stopping cold turkey makes anxiety worse by a long shot and like you experienced, induces brainzaps.
 
crisler said:
As for the reversible one you just stated maybe you can specifically request it to see if the combo is safe with a drug that is reversable if things go sour
Click to expand...

He wouldn't have to "specifically request" a reversible MAOI. At this point, irreversible MAOIs (besides the use of Selegiline and Rasagiline in the treatment of Parkinsonism) are virtually unheard of in Europe. Only the most experienced psychiatrists are still willing to prescribe them to treat depression, which is a fucking shame.

And let me point something out: The biggest danger for people with severe mental illnesses isn't drug interactions, it's blowing their brains out because life has become unbearable for them. Or worse yet, being forced to live a life of constant suffering because the disease even saps them of the will to kill themselves.
 
Hodor said:
He wouldn't have to "specifically request" a reversible MAOI. At this point, irreversible MAOIs (besides the use of Selegiline and Rasagiline in the treatment of Parkinsonism) are virtually unheard of in Europe. Only the most experienced psychiatrists are still willing to prescribe them to treat depression, which is a fucking shame.

And let me point something out: The biggest danger for people with severe mental illnesses isn't drug interactions, it's blowing their brains out because life has become unbearable for them. Or worse yet, being forced to live a life of constant suffering because the disease even saps them of the will to kill themselves.
Click to expand...

What a fantastic reply and so very true.

I cant even collect my daughter because of this agoraphobia and she is my world......Yet the Shrink discharged me, when I asked why he said its because I am not a danger to myself or to others so he has reffered me back to my GP.....The GP that said coming off of 1mg of Klon for 6 years and taking 10mg Amitrptiline (spelling?) would be fine and I would have no withdrawal effects.....What a total tw@t!
 
Very excellent thread. Twat indeed. I would try maybe adjusting your dose of Clonazepam, or trying one of the other cool ones you have in your section of the world. If you hate benzodiazepines, maybe a small dose of a weak one. I just don't like ami. In my experience in the US, most GP's don't know much about psych stuff. If you have the ability, seek out a better psych Doctor.
 
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