Guest guest Posted February 5, 2000 Report Share Posted February 5, 2000 (and ). > What are the possible contraindications of the combination of Deprenyl & > tryptophan? As far as I know it should be safe to take tryptophan with Deprenyl (selegiline). In fact the serotonin syndrome problem seems to be only barely present even in people who take Deprenyl with SSRI's like Prozac. According to this abstract below, estimates are that less than 1% of Parkinson's patients treated with both selegiline and antidepressants had problems. Title Serotonin syndrome and the combined use of deprenyl and an antidepressant in Parkinson's disease. Parkinson Study Group. Author IH ; Kurlan R ; Tanner C ; Factor S ; Hubble J ; Suchowersky O ; Waters C Address University of Rochester Medical Center, Department of Neurology, NY 14642-8673, USA. Source Neurology, 48(4):1070-7 1997 Apr Abstract The manufacturer of deprenyl (selegeline; Eldepryl) (Somerset Pharmaceuticals, Tampa, FL) recently advised physicians to avoid prescribing the drug in combination with an antidepressant because of potentially serious CNS toxicity that may represent the serotonin syndrome. Manifestations of the serotonin syndrome vary but may include changes in mental status and motor and autonomic function. To better estimate the frequency of the serotonin syndrome in patients with Parkinson's disease (PD) treated with deprenyl and an antidepressant, we surveyed all investigators in the Parkinson Study Group. Based on estimates provided by the 47 investigators (75%) who responded, 4,568 patients were treated with the combination of deprenyl and an antidepressant medication. Eleven patients (0.24%) were reported to have experienced symptoms possibly consistent with the serotonin syndrome. Only two patients (0.04%) experienced symptoms considered to be serious. No deaths were reported. We also reviewed all published case reports and adverse experiences reported to the U.S. Food and Drug Administration and the manufacturer of Eldepryl. Available information indicates that serious adverse experiences resulting from the combined use of deprenyl and an antidepressant medication in patients with PD are quite rare and that the frequency of the true " serotonin syndrome " is even rarer. Language Eng Unique Identifier 97264030 -gts Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2000 Report Share Posted February 6, 2000 In theory tryptophan is converted to serotonin once it enters the blood brain barrier. I suspect that the levels of serotonin would be relatively low. > (and ). > > > What are the possible contraindications of the combination of Deprenyl & > > tryptophan? > >As far as I know it should be safe to take tryptophan with Deprenyl >(selegiline). > >In fact the serotonin syndrome problem seems to be only barely present even >in people who take Deprenyl with SSRI's like Prozac. According to this >abstract below, estimates are that less than 1% of Parkinson's patients >treated with both selegiline and antidepressants had problems. > > >Title >Serotonin syndrome and the combined use of deprenyl and an antidepressant in >Parkinson's disease. Parkinson Study Group. >Author > IH ; Kurlan R ; Tanner C ; Factor S ; Hubble J ; Suchowersky O ; >Waters C >Address >University of Rochester Medical Center, Department of Neurology, NY >14642-8673, USA. >Source >Neurology, 48(4):1070-7 1997 Apr >Abstract >The manufacturer of deprenyl (selegeline; Eldepryl) (Somerset >Pharmaceuticals, Tampa, FL) recently advised physicians to avoid prescribing >the drug in combination with an antidepressant because of potentially >serious CNS toxicity that may represent the serotonin syndrome. >Manifestations of the serotonin syndrome vary but may include changes in >mental status and motor and autonomic function. To better estimate the >frequency of the serotonin syndrome in patients with Parkinson's disease >(PD) treated with deprenyl and an antidepressant, we surveyed all >investigators in the Parkinson Study Group. Based on estimates provided by >the 47 investigators (75%) who responded, 4,568 patients were treated with >the combination of deprenyl and an antidepressant medication. Eleven >patients (0.24%) were reported to have experienced symptoms possibly >consistent with the serotonin syndrome. Only two patients (0.04%) >experienced symptoms considered to be serious. No deaths were reported. We >also reviewed all published case reports and adverse experiences reported to >the U.S. Food and Drug Administration and the manufacturer of Eldepryl. >Available information indicates that serious adverse experiences resulting >from the combined use of deprenyl and an antidepressant medication in >patients with PD are quite rare and that the frequency of the true > " serotonin syndrome " is even rarer. >Language >Eng >Unique Identifier >97264030 > >-gts > > > >------------------------------------------------------------------------ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2000 Report Share Posted February 6, 2000 Yes, it seems highly unlikely that a natural precursor like tryptophan could ever cause serotonin syndrome in combination with selegiline given that it is only barely established even that strong SSRI drugs might be a problem with selegiline. The more I investigate this subject, the less concerned I become about combining small doses of SSRI's with selegiline, although I suppose it is the sort of thing that should be done only with a doctor's supervision. (Actually we're talking about combining two prescription drugs here, so I should hope there would be a doctor in the picture somewhere! -gts Re: Deprenyl & Tryptophan > In theory tryptophan is converted to serotonin once it enters the > blood brain barrier. I suspect that the levels of serotonin would be > relatively low. > > > > > > > (and ). > > > > > What are the possible contraindications of the combination of Deprenyl & > > > tryptophan? > > > >As far as I know it should be safe to take tryptophan with Deprenyl > >(selegiline). > > > >In fact the serotonin syndrome problem seems to be only barely present even > >in people who take Deprenyl with SSRI's like Prozac. According to this > >abstract below, estimates are that less than 1% of Parkinson's patients > >treated with both selegiline and antidepressants had problems. > > > > > >Title > >Serotonin syndrome and the combined use of deprenyl and an antidepressant in > >Parkinson's disease. Parkinson Study Group. > >Author > > IH ; Kurlan R ; Tanner C ; Factor S ; Hubble J ; Suchowersky O ; > >Waters C > >Address > >University of Rochester Medical Center, Department of Neurology, NY > >14642-8673, USA. > >Source > >Neurology, 48(4):1070-7 1997 Apr > >Abstract > >The manufacturer of deprenyl (selegeline; Eldepryl) (Somerset > >Pharmaceuticals, Tampa, FL) recently advised physicians to avoid prescribing > >the drug in combination with an antidepressant because of potentially > >serious CNS toxicity that may represent the serotonin syndrome. > >Manifestations of the serotonin syndrome vary but may include changes in > >mental status and motor and autonomic function. To better estimate the > >frequency of the serotonin syndrome in patients with Parkinson's disease > >(PD) treated with deprenyl and an antidepressant, we surveyed all > >investigators in the Parkinson Study Group. Based on estimates provided by > >the 47 investigators (75%) who responded, 4,568 patients were treated with > >the combination of deprenyl and an antidepressant medication. Eleven > >patients (0.24%) were reported to have experienced symptoms possibly > >consistent with the serotonin syndrome. Only two patients (0.04%) > >experienced symptoms considered to be serious. No deaths were reported. We > >also reviewed all published case reports and adverse experiences reported to > >the U.S. Food and Drug Administration and the manufacturer of Eldepryl. > >Available information indicates that serious adverse experiences resulting > >from the combined use of deprenyl and an antidepressant medication in > >patients with PD are quite rare and that the frequency of the true > > " serotonin syndrome " is even rarer. > >Language > >Eng > >Unique Identifier > >97264030 > > > >-gts > > > > > > > >------------------------------------------------------------------------ > > Quote Link to comment Share on other sites More sharing options...
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