Expert: Barbara Judge - 6/9/2009

Question
I am curious. Can a methadone patient take an MAOI like Parnate or Nardil? My general doc says its risky but my pscyhiatrist says its ok as long as I stick to the dietary concerns. Can you give me a 3rd opinion? I don't want to go into seratonin syndrome

Answer
    It is generally not recommended that a patient take both an MAOI and methadone or any other narcotic analgesic.  While the risk of interactions varies, it is a severe interaction which can lead to very low blood pressure, respiratory depression, and coma.  The interaction does not seem to be dependent on food, but rather the dose of medications you have taken.  It is also not a seratonin syndrome like reaction.  I would consult with both doctors again because their are probably better choices of pain medications available if the patient must be on an MAOI. If the patient must be on methadone then I would be looking for alternatives to the MAOI.

Thanks


Barb Judge