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Friday, October 31, 2014
Remeron interactions with PD medications?
Can you tell me if the new tetracyclic antidepressant Remeron would be dangerous to take with Sinemet and selegiline?
The main concern when using antidepressants such as Remeron with selegiline is the possibility of a hypertensive crisis. This refers to a marked increase in blood pressure that can then predispose to heart attack or stroke. When selegeline is taken in low doses (10 mg or less) it acts as a specific inhibitor of MAO-B, an enzyme in the brain. At such doses this interaction is less likely. At higher doses selegeline loses its selectivity for MAO-B and becomes a non-specific inhibitor of MAO-A and B. In such a case these interactions are much more likely. Thus the answer to your question would depend on many specifics: drug dosages, your baseline blood pressure, history of heart disease and stroke etc. You should discuss these in detail with your doctor before making a decision.
Arif Dalvi, MD
College of Medicine
University of Cincinnati