Antidepressant Chemotherapy—Rapid Response to Serotonin Precursor Potentiated by Ritalin
Great improvement is observed in many depressed patients upon treatment with a combination of MAO inhibitors, serotonin precursor, and antihypotensive drugs. The authors have found Marplan to be the most effective antidepressant when used in conjunction with the antihypotensive Florinef to prevent syncope. A combination of serotonin precursor (5-HTP) and Ritalin (to compensate for metabolic inability to decarboxylate 5-HTP into serotonin) enhances the effect of MAO inhibitors, but also increases the danger of hypotension. Sitting and upright blood pressure recordings must be taken regularly and drug dosages modified accordingly. Intermittent blood potassium and SGO-transaminase tests are also necessary. Serotonin deficiency is usually chronic in melancholia and will return after MAOI effects wear off unless maintenance precursor therapy is continued. The interval between office visits can be increased if patients are willing to record their own blood pressures at home and take Florinef as required.