Consider stopping antidepressants before SN method

[penguinl0v3s]

For those that don't know, the only treatment for methemoglobinemia is methylene blue. Methylene blue has a similar structure to MAOIs, a class of anti-depressants, and when multiple types of antidepressants are mixed together it puts you at greater risk of serotonin syndrome.

Serotonin syndrome does not often kill, but is very unfortunate to experience. While nobody wants to consider failure, it's not much extra added work to mitigate potential pain and an extra $1k of hospital fees just in case.

Half-life and life of antidepressants

Going Off Antidepressants - Harvard Health Publishing - Harvard Health

People who have been taking antidepressants for some time may wish to stop taking them due to unpleasant side effects. This can be accomplished, but it is best to taper the dosage slowly and be awa...

www.health.harvard.edu

Serotonin toxicity:

Methaemoglobinemia Induced by Poppers and Bupropion Intoxication in the Emergency Department - PubMed

Distinguishing toxidromes is critical for adequate treatment of patients with drug intoxication; the most common side effect of bupropion consumption is dose-dependent seizures.The diagnosis of methaemoglobinemia requires a high index of suspicion, particularly in a patient presenting with...

pubmed.ncbi.nlm.nih.gov

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2078225/

Serotonin Toxicity and Urinary Analgesics: A Case Report and Systematic Literature Review of Methylene Blue-Induced Serotonin Syndrome - PubMed

Methylene blue can induce SS, felt to be secondary to MAOI properties. Although previous reports have exclusively been associated with MB given via parental administration, our case suggests that SS can be induced by oral administration of MB-containing agents.

pubmed.ncbi.nlm.nih.gov

 

[LaVieEnRose]

I agree that drug interactions should be reviewed beforehand.