Posted by hopefullynow on November 23, 2009, at 5:41:33
In reply to Re: Treatment resistant OCD » hopefullynow, posted by Phidippus on November 22, 2009, at 14:01:13
> No CYP problems that I can find of between Flouxetine and Clomipramine.Hy,
Regarding Anafranil plus Prozac combo, I found something:Clomipramine and Fluoxetine
Clomipramine is a serotonin reuptake inhibitor while its principalmetabolite, desmethylclomipramine is a noradrenalin reuptake inhibitor. Paroxetine and fluoxetine (and its principal metabolite norfluoxetine) are strong inhibitors of CYP2D6 preventing the breakdown of desmethylclomipramine. As levels of this metabolite increase the anti-OCD benefits of clomipramine (associated primarily with its serotonergic activity) are reduced. Additionally, blocking CYP2D6 also lowers levels of 8-hydroxyclomipramine, which has significant serotonergic activity and may play a part in the overall activity of clomipramine. Note 5301 Reviewed 2009-02-03.
From what I understand, norfluoxetine prevents the breakdown of desmethylclomipramine, the "serotonergic metabolite" of Anafranil,lowering its serotonergic properties, so this combo become more NSRI than SNRI, which is not benefic for OCD and anxiety.
>
> Would this approach work with Lexapro?Lexapro plus Prozac?
I am pretty sure that it will work, Lexapro is in its class of SSRI what Anafranil is as TCA.Regarding CYP interactions, there are some, it seems that Lex and Prozac potentiates each other:-Prozac levels rise 0-25% because of Lexapro
-Norfluoxetine (active metabolite) levels rise 75-150% because of Lexapro-Lexapro levels rise 0-25% because of Prozac
poster:hopefullynow
thread:926438
URL: http://www.dr-bob.org/babble/20091117/msgs/926665.html