Demerol is a powerful narcotic analgesic with some selective effects
that increase the toxicity of Eldeprel, frequently with a lethal outcome.
This is thought to be due to inhibition of monoamine oxidase, the enzyme
that calatalyzes inactivation of monoamines. MAO-A is the major source of
amine inactivation in the central nervous system, and this is probably the
mechanism of MAO inhibitors as antidepressants. Demerol inhibits both the A
and B isoforms of MAO additively, so that demerol worsens the toxic effects
of Eldeprel, most severely in the cardiovacular and nervous systems.
Evidence has recently beeen published to support this hypothesis of
demerol-Eldeprel interaction. This may be sufficient for Eldeprel to be
removed from the roster of anti-PD drugs. Demerol is a difficult enough
analgesic to use without adding another source of threat to life.
Your Dad's hallucinatory response to demerol may be explained
entirely by what I wrote above, but we can't be sure. Most anti-PD drugs can
have unpredictable side effects. Just make sure that the next time your dad
is treated with analgesics that the physician knows what he already has on
board.
The best to you;
Steven E. Mayer [log in to unmask]
>
Steven E. Mayer, Ph.D.
