COMBINING THE ANTIDEPRESSANT DRUGS

Changes in body temperature after administration of adrenergic and serotonergic agents and related drugs including antidepressants: II

This survey continues a second series of compilations of data regarding changes in body temperature induced by drugs and related agents. The information listed includes the species used, the route of administration and dose of drug, the environmental temperature at which experiments were performed, the number of tests, the direction and magnitude of change in body temperature and remarks on the presence of special conditions, such as age or brain lesions. Also indicated is the influence of other drugs, such as antagonists, on the response to the primary agent. Most of the papers were published from 1980 to 1984 but data from many earlier papers are also tabulated.

Malignant hyperthermia caused by salicylate overdose associated with phenelzine therapy-a case report

A patient was admitted following a self-administered salicylate overdose. She rapidly deteriorated and died in spite of resuscitative measures. Features of her death included hyperthermia convulsions, hypoxia, acidaemia, extreme muscular rigidity, a high serum creatine phosphokinase, hypocalcaemia, hyperphosphataemia, raised potassium, and increasingly abnormal coagulation parameters. The patient had been receiving phenelzine 45 mg daily but none was detected on analysis of gastric aspirate. Her serum salicylate level was extremely high (120 mg/100 ml).

Malignant hyperthermia, its association with monoamine oxidase inhibitors, and its possible relationship in this case to salicylate overdosage with acidaemia are discussed.

A study of refractory cases of depressive illnesses and their response to combined antidepressant treatment

Opinions differ on the effectiveness and the risk involved in treating depressive illnesses with combinations of monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants. Some authorities, including the Food and Drug Administration in the United States, the former Witts Committee in this country, and the pharmaceutical firms producing antidepressants, have given serious warnings against combining MAOIs with tricyclic antidepressants. These warnings have been repeated more recently by Beck (1967), Malitz (1966) and Shepherd et al. (1968).