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hi jay you wrote: >:-) :-) :-) >... >Janet........are you awake now? >Question! For quite some time now, it has been my understanding >that Selegiline and Prozac could be a problem when prescribed >together. If you have a comment or two regarding this issue, >please share. >Aloha! >Jay Henkelman >48/8++ Sinemet/Selegiline >[log in to unmask] i was awake and then i wasn't... but i think i am now! i've copied three abstracts of medical studies on the issue below i think the key here is "could be a problem" with a big emphasis on the "could" in my humble opinion somerset pharmaceuticals' legal department are simply being hyper-vigilant to the extent of causing needless worry this may be a case of a 'syndrome' that exists only on paper my history = 7 years of this drug combination, no problems more info is available for digging at our list archive site: http://new.parkinsons.org.uk/index.htm and at the pubmed site: http://www.ncbi.nlm.nih.gov/PubMed/ aloha back! as a former islander, may i ask, dare i ask, where you aloha from? your cyber-sibling in sinemet/selegiline/serotonin swillage janet janet paterson 51/10 - sinemet/selegiline/prozac almonte/ontario/canada - [log in to unmask] ---------------------------------------------------------------- TITLE: Retrospective study of selegiline-antidepressant drug interactions and a review of the literature. ABSTRACT: Selegiline [trade name Eldepryl] is a selective monoamine oxidase inhibitor used in the treatment of Parkinson's disease. It is estimated that approximately one-half of Parkinsonian patients will develop depression requiring antidepressant drug treatment. Recently, selegiline's package insert was revised to reflect the potential risk of adverse effects when it is used in combination with selective serotonin reuptake inhibitors and tricyclic antidepressants. The objective of our study is to assess the safety of combining selegiline with antidepressants. A retrospective chart review was performed on all 28 patients with Parkinson's disease receiving selegiline and antidepressants concurrently to identify possible drug interactions. Compliance was assessed according to prescription refill records. Suspected adverse reactions with combination therapy were documented. There was a total of 40 selegiline-antidepressant drug combinations involving tricyclic antidepressants (n = 25), selective serotonin reuptake inhibitors (n = 7), trazodone (n = 5), and bupropion (n = 3). One patient receiving fluoxetine [trade name Prozac] developed a reaction consistent with the serotonin syndrome; however, it was never documented as such. No other selegiline drug interactions were found. Adverse effects noted were typical of antidepressant monotherapy. Although no selegiline drug interactions were documented in our study, the concurrent administration of selegiline and selective serotonin reuptake inhibitors should be avoided because of literature-reported interactions. We believe that bupropion, tricyclic antidepressants, and trazodone are reasonable choices in combination with selegiline, although tricyclic antidepressants and trazodone may be reserved as second-line treatments. Ritter JL, Alexander B University of Washington Medical Center, Seattle 98105, USA. Ann Clin Psychiatry 1997 Mar;9(1):7-13 PMID: 9167831, UI: 97310932 ---------------------------------------------------------------- TITLE: 'Serotonin syndrome' and the combined use of selegiline/deprenyl/eldepryl and an anti-depressant in Parkinson's disease. Parkinson Study Group. 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. Richard IH, Kurlan R, Tanner C, Factor S, Hubble J, Suchowersky O, Waters C University of Rochester Medical Center, NY 14642-8673, USA Neurology 1997 Apr;48(4):1070-1077 PMID: 9109902, MUID: 97264030 ---------------------------------------------------------------- TITLE: Fluoxetine and selegiline--lack of significant interaction. ABSTRACT: The use of the combination of fluoxetine [trade name Prozac], an anti-depressant serotonin uptake inhibitor, and selegiline [trade name Eldepryl] a monoamine oxidase -B inhibitor, was reviewed in a large population of patients with Parkinson's disease. All records were reviewed from a Parkinson's disease clinic to determine how many patients were treated simultaneously with selegiline and fluoxetine. Patient characteristics, duration and dose of treatment, side effects and reasons for discontinuation were noted. Twenty-three patients received both medications at the same time. No additional side effects were noted with the combination therapy that had not already been reported with each medication alone. No serious side effects were found. In this clinic population, fluoxetine and selegiline were used in combination without major side effects, but further observation is warranted. Can J Neurol Sci 1994 Aug;21(3):259-261 Waters CH Department of Neurology, University of Southern California, Los Angeles 90033. PMID: 8000982, UI: 95094107 ----------------------------------------------------------------