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Parkinson's Disease

Remeron interactions with PD medications?

03/20/2000

Question:

Can you tell me if the new tetracyclic antidepressant Remeron would be dangerous to take with Sinemet and selegiline?

Answer:

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.

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Response by:

Arif Dalvi, MD
Assistant Professor
College of Medicine
University of Cincinnati