Combinations - Methadone and Selegiline

[Dole654]

Hello!

I was reading up on the pharmacology of both Methadone and Selegiline (more specifically EMSAM, even more specifically 6mg / 24hr - selective for MAOI-B), and came upon something of interest. Methadone appears to inhibit the reuptake of serotonin. Obviously taking SSRIs and MAOIs is generally not the wisest idea - serotonin storm lurks in the background...

But, I have also read about the use of an SSRI in combination with EMSAM.
So, my two questions seem to be, how strong of an SSRI is methadone, and is the risk of serotonin syndrome really that prevalent?

Thanks!

[Paracelsus]

As you said, selegiline is MAO-B selective. Serotonin is deaminated by MAO-A, so there is no risk of serotonin syndrome unless high doses of selegiline are used (at which it loses its selectivity and inhibits MAO-A to a significant degree).

[SeconalClerek]

Its at about ~30mg that Selegiline looses it's MAO-B preference and becomes, with increasing dose an unselective MAOI,

Clerek