Posted by Adam on September 13, 1999, at 18:41:16
In reply to MAOI/Reboxetine Combo For "Cheese Effect", posted by Winterlight on September 6, 1999, at 21:58:49
I've seen only one reference to support this idea:
Reboxetine prevents the tranylcypromine-induced
increase in tyramine levels in rat heart
by
Dostert P, Castelli MG, Cicioni P, Strolin Benedetti M
Farmitalia Carlo Erba,
Research and Development,
Erbamont Group, Milan, Italy.
J Neural Transm Suppl 1994; 41:149-53ABSTRACT
This study aimed to examine whether the increase in heart radioactivity levels after intravenous
injection of 14C-tyramine to rats pretreated with the irreversible MAO inhibitor tranylcypromine could be
antagonized by reboxetine, a potent and selective noradrenaline uptake blocker. Reboxetine was found
totally to abolish the effect of tranylcypromine. Heart radioactivity levels after reboxetine and
tranylcypromine were very similar to those found when tyramine was injected after reboxetine only.
These results suggest that reboxetine might be advantageously combined with tranylcypromine, or any
MAO inhibitor, in depressed patients unresponsive of either treatment given alone.Have you seen others?
Anyway, I personally have some difficulties with the leap from the authors' findings to abrogation of the "cheese effect". I'm not sure their
experimental approach has much clinical relevance. Plus, as Elizabeth pointed out somewhere, there's already some precendent for this idea in
the use of certain tricyclics (which, being fairly potent noradrenergics/NE-reuptake inhibitors might do the same thing), but nobody seems to be
using this approach in practice...I assume because it doesn't work.My guess is that since certain TCA/MAOI combos are used in treatment, adding rebox. to an MAOI ought to be safe. Umm, JohnB, how does your doc
plan on testing the idea? I know the cheese effect is rarely lethal, but it can be pretty uncomfortable, from what I understand, and is potentially
dangerous. I can imagine such an experiment might raise some serious eyebrows in certain circles. If somebody gave a Rehsus monkey rebox+parnate+a
bunch of tyramine orally and it's was OK, I might feel bit more confident this is a good idea.
> Read several suggestions in literature recently that the NARI reboxetine may eliminate/modify the need for dietary restrictions if administered with the classic MAO inhibitors. What's the latest scientific information on this combination. Has anyone out there tried this combination with success?
> It seems to me that, if true, this MAOI/NARI cocktail might prove to be one of the most potent anti-depressant treatments ever.
poster:Adam
thread:11149
URL: http://www.dr-bob.org/babble/19990914/msgs/11528.html