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--------------60774E0F5C35671D39EB2568 Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit Hi Janet! My aloha comes from Oregon. Actually Aloha, Oregon.......seriously! However, my aloha(s) are each created with the "Island spirit" only fully appreciated by their past & present residents. I spent many years in Hawaii, specifically near Diamond Head (Hawaii Kai) on Oahu as well as on Kauai for a short time. Janet, I realize that Canada must be a magical place :-) but the aloha I send to you is a very special one......for the Islands will be "calling you" for the rest of your life. Much aloha! Jay Henkelman 48/8++Sinemet/Selegiline [log in to unmask] ------------------------------------------------------------------------ Janet313 wrote: > 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 > ---------------------------------------------------------------- --------------60774E0F5C35671D39EB2568 Content-Type: text/html; charset=us-ascii Content-Transfer-Encoding: 7bit <HTML> Hi Janet! <P>My aloha comes from Oregon. Actually Aloha, Oregon.......seriously! However, my aloha(s) are each created with the "Island spirit" only fully appreciated by their past & present residents. I spent many years in Hawaii, specifically near Diamond Head (Hawaii Kai) on Oahu as well as on Kauai for a short time. <P>Janet, I realize that Canada must be a magical place :-) but the aloha I send to you is a very special one......for the Islands will be "calling you" for the rest of your life. <P>Much aloha! <P>Jay Henkelman <BR>48/8++Sinemet/Selegiline <BR>[log in to unmask] <BR> <HR WIDTH="100%"> <P>Janet313 wrote: <BLOCKQUOTE TYPE=CITE>hi jay <P>you wrote: <BR>>:-) :-) :-) <BR>>... <BR>>Janet........are you awake now? <BR>>Question! For quite some time now, it has been my understanding <BR>>that Selegiline and Prozac could be a problem when prescribed <BR>>together. If you have a comment or two regarding this issue, <BR>>please share. <BR>>Aloha! <BR>>Jay Henkelman <BR>>48/8++ Sinemet/Selegiline <BR>>[log in to unmask] <P>i was awake and then i wasn't... <BR>but i think i am now! <P>i've copied three abstracts of medical studies on the issue below <BR>i think the key here is "could be a problem" <BR>with a big emphasis on the "could" <P>in my humble opinion <BR>somerset pharmaceuticals' legal department <BR>are simply being hyper-vigilant <BR>to the extent of causing <BR>needless worry <P>this may be a case of a 'syndrome' that exists only on paper <BR>my history = 7 years of this drug combination, no problems <P>more info is available for digging <BR>at our list archive site: <BR><A HREF="http://new.parkinsons.org.uk/index.htm">http://new.parkinsons.org.uk/index.htm</A> <BR>and at the pubmed site: <BR><A HREF="http://www.ncbi.nlm.nih.gov/PubMed/">http://www.ncbi.nlm.nih.gov/PubMed/</A> <P>aloha back! <BR>as a former islander, may i ask, dare i ask, where you aloha from? <P>your cyber-sibling in sinemet/selegiline/serotonin swillage <P>janet <P>janet paterson <BR>51/10 - sinemet/selegiline/prozac <BR>almonte/ontario/canada - [log in to unmask] <P>---------------------------------------------------------------- <BR>TITLE: Retrospective study of selegiline-antidepressant drug interactions and <BR>a review of the literature. <P>ABSTRACT: Selegiline [trade name Eldepryl] is a selective monoamine oxidase <BR>inhibitor used in the treatment of Parkinson's disease. <P>It is estimated that approximately one-half of Parkinsonian patients will <BR>develop depression requiring antidepressant drug treatment. <P>Recently, selegiline's package insert was revised to reflect the potential <BR>risk of adverse effects when it is used in combination with selective <BR>serotonin reuptake inhibitors and tricyclic antidepressants. <P>The objective of our study is to assess the safety of combining selegiline <BR>with antidepressants. <P>A retrospective chart review was performed on all 28 patients with Parkinson's <BR>disease receiving selegiline and antidepressants concurrently to identify <BR>possible drug interactions. <P>Compliance was assessed according to prescription refill records. <P>Suspected adverse reactions with combination therapy were documented. <P>There was a total of 40 selegiline-antidepressant drug combinations involving <BR>tricyclic antidepressants (n = 25), selective serotonin reuptake inhibitors (n <BR>= 7), trazodone (n = 5), and bupropion (n = 3). <P>One patient receiving fluoxetine [trade name Prozac] developed a reaction <BR>consistent with the serotonin syndrome; however, it was never documented as <BR>such. <P>No other selegiline drug interactions were found. <P>Adverse effects noted were typical of antidepressant monotherapy. <P>Although no selegiline drug interactions were documented in our study, the <BR>concurrent administration of selegiline and selective serotonin reuptake <BR>inhibitors should be avoided because of literature-reported interactions. <P>We believe that bupropion, tricyclic antidepressants, and trazodone are <BR>reasonable choices in combination with selegiline, although tricyclic <BR>antidepressants and trazodone may be reserved as second-line treatments. <P>Ritter JL, Alexander B <BR>University of Washington Medical Center, Seattle 98105, USA. <BR>Ann Clin Psychiatry 1997 Mar;9(1):7-13 <BR>PMID: 9167831, UI: 97310932 <P>---------------------------------------------------------------- <BR>TITLE: 'Serotonin syndrome' and the combined use of <BR>selegiline/deprenyl/eldepryl and an anti-depressant in Parkinson's disease. <BR>Parkinson Study Group. <P>ABSTRACT: The manufacturer of deprenyl/selegeline/Eldepryl (Somerset <BR>Pharmaceuticals, Tampa, FL) recently advised physicians to avoid prescribing <BR>the drug in combination with an antidepressant because of potentially serious <BR>CNS toxicity that may represent the 'serotonin syndrome'. <P>Manifestations of the 'serotonin syndrome' vary but may include changes in <BR>mental status and motor and autonomic function. <P>To better estimate the frequency of the 'serotonin syndrome' in patients with <BR>Parkinson's disease (PD) treated with deprenyl and an antidepressant, we <BR>surveyed all investigators in the Parkinson Study Group. <P>Based on estimates provided by the 47 investigators (75%) who responded, 4,568 <BR>patients were treated with the combination of deprenyl and an antidepressant <BR>medication. <P>Eleven patients (0.24%) were reported to have experienced symptoms possibly <BR>consistent with the 'serotonin syndrome'. <P>Only two patients (0.04%) experienced symptoms considered to be serious. <P>No deaths were reported. <P>We also reviewed all published case reports and adverse experiences reported <BR>to the U.S. Food and Drug Administration and the manufacturer of Eldepryl. <P>Available information indicates that serious adverse experiences resulting <BR>from the combined use of deprenyl and an antidepressant medication in patients <BR>with PD are quite rare and that the frequency of the true "serotonin syndrome" <BR>is even rarer. <P>Richard IH, Kurlan R, Tanner C, Factor S, <BR>Hubble J, Suchowersky O, Waters C <BR>University of Rochester Medical Center, NY 14642-8673, USA <BR>Neurology 1997 Apr;48(4):1070-1077 <BR>PMID: 9109902, MUID: 97264030 <P>---------------------------------------------------------------- <BR>TITLE: Fluoxetine and selegiline--lack of significant interaction. <P>ABSTRACT: The use of the combination of fluoxetine [trade name Prozac], an <BR>anti-depressant serotonin uptake inhibitor, and selegiline [trade name <BR>Eldepryl] a monoamine oxidase -B inhibitor, was reviewed in a large population <BR>of patients with Parkinson's disease. <P>All records were reviewed from a Parkinson's disease clinic to determine how <BR>many patients were treated simultaneously with selegiline and fluoxetine. <P>Patient characteristics, duration and dose of treatment, side effects and <BR>reasons for discontinuation were noted. <P>Twenty-three patients received both medications at the same time. <P>No additional side effects were noted with the combination therapy that had <BR>not already been reported with each medication alone. <P>No serious side effects were found. <P>In this clinic population, fluoxetine and selegiline were used in combination <BR>without major side effects, but further observation is warranted. <P>Can J Neurol Sci 1994 Aug;21(3):259-261 <BR>Waters CH <BR>Department of Neurology, University of Southern California, Los Angeles 90033. <BR>PMID: 8000982, UI: 95094107 <BR>----------------------------------------------------------------</BLOCKQUOTE> </HTML> --------------60774E0F5C35671D39EB2568--