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Re: Moclo + Stimulants

Posted by ben on January 22, 2002, at 2:02:53

In reply to Moclo + Stimulants » ben, posted by TSA West on January 21, 2002, at 15:48:00

It is right to be careful but:
My pdoc combines it often carefully with Methylphenidate as TCAs or SSRIs as well instead of the theoretical interactions. It depends on individual metabolism ! There are cases of serotonine syndrome with the use of SSRIs or Clomipramine alone. The SSRI Citalopram (Celexa) isnt recommended to be given more than 60 mg/day. There are a few pdocs titrating up to 140 mg/day ! if somone have a partial response and poops out at each new dose step.
And especially moclobemide is metabolized by 2C19. An enzyme with polymorphism: that means population with normal/slow or fast metabolism -- > resulting great differences in plasma levels! Ultra rapid metabolizers need moclobemid up to 1800 mg ! This is seldom but can be fatal if the pdoc means the patient isnt responding (at normal doses) because he isnt aware of the patients matabolism !

With > As with all MAOI/moclobemide be careful with using added stimulants, as they can cause blood pressure problems...
>
> I believe buproprion is acceptable as an augmenting and stimulating antidepressant with Moclobemide though (http://pandora.nla.gov.au/nph-arch/O1998-May-8/http://www.medfac.unimelb.edu.au/ap/volume18/issue4/ap18-4-9.html)


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