We have had good experience with Newlife Medicare Private Limited*** who supply Trivon, a reputable generic Tranylcypromine manufactured by Intas.  (has been officially available in India for several years). www.indiamart.com Newlife Medicare Private Limited – Offering Trivon Tranylcypromine Tablet, Prescription, Treatment: Anti Depressent at Rs 180/strip in Nagpur, Maharashtra. Also find Tranylcypromine Tablet price list | ID: 26219311062 ? https://www.indiamart.com/proddetail/trivon-tranylcypromine-tablet-26219311062.html Their rate is ~USD 2.50 per 10 tablet strip and Intas manufact ..read more

The helpers involved with PsychoTropical periodically relay messages from ‘media platforms’ which need correction or modification.  I am concerned that there are many comments giving, and relaying, opinions and advice that come from people, including medical and para-medical writers, who clearly have insufficient knowledge or experience to give any useful opinion, or to impart accurate knowledge — such opinions go well beyond the knowledge or experience of the people giving them.  A proportion of people making such posts are dangerous because they do not recognise that they do not ..read more

Hobart talk, Oct 24th 2023. RANZPsych. MAOIs: indications, usage, and interactions The talk itself concentrates general aspects and principles.  Details are here in key references for those who wish to understand more about the substantive evidence and to study in greater depth. Supplementary information & resources References, numbers as in PPT slides from the talk Ioannidis, J.P., Why most published research findings are false. Public Library of Science: Medicine, 2005. 2(8): p. e124. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&l ..read more

Content coming soon Menu 1. Hobart Talk and Supplementary Information 14 November 2023 2. Suggested Treatment Pathway to Consider 14 November 2023 Consider Donating to PsychoTropical PsychoTropical is funded solely through generous donations, which has enabled extensive development and improvement of all associated activities. Many people who follow the advice on the website will save enormously on doctors, treatment costs, hospitalization, etc. which in some cases will amount to many thousands of dollars, even tens of thousands — never mind all the reduction in suffering and ..read more

Introduction [KG] This story well illustrates the long periods of unnecessary illness and suffering that many patients experience as result of the reluctance doctors exhibit to use these effective and safe older MAOI drugs.  Doctors’ attention is so diverted to all the shiny new stuff that is heavily promoted and advertised, including taking doctors on luxury five-star trips to foreign resorts — one correspondent recently told me his whole family was included in the trip —- I am sure the cost of that trip was greater than any holiday I have taken. As this account reminds us, it is the e ..read more

There is little to add to this gentleman’s story which is succinct and encapsulates the most common difficulties where doctors simply do not proceed sufficiently promptly to alternative, and probably more effective, treatments.  His comments about CBT remind me of what I have often said to patients, which is that if you’re able to fully engage with CBT, then you have not got significant anergia and anhedonia, and if you do have significant anergia and anhedonia, then you cannot do CBT – indeed, trying to do it when you are inevitably going to be unsuccessful is like rubbing salt into t ..read more

Neuroscience-based criteria for assessing serotonin-mediated effects of drugs: defining and predicting which drugs cause serotonin toxicity Setting the record straight There continues to be a great deal of confusion and misunderstanding concerning which drugs may be capable of precipitating serotonin toxicity(ST).  This has been fuelled by lack of knowledge about pharmacology and particularly by over-extrapolation from unreliable case reports (many published by predatory journals and journals incapable of quality peer review —- to the extent that quality peer review still exists).  T ..read more

Ergotamine, bromocriptine and LSD This is an interesting and obscure aspect of the serotonin toxicity saga, yes, it really is a saga.  One of my mentors was Mervyn Eadie, Professor of Neurology in Brisbane.  He has written some fascinating historical papers. One of them is ‘Convulsive ergotism: epidemics of the serotonin syndrome’ [1].  His observation below, ‘Dihydroergotamine given to human beings can cause the serotonin syndrome’, refers to the case reported by Mathew, related to IV use, which is rare now [2]. He suggests, ‘The serotonin syndrome may, therefore, have been ..read more

Normothermia, fever and hyperthermia The term ‘hyperthermia’ is used without definition in the general ST, and much other, literature.  The term ‘fever’ is often used imprecisely instead of hyperthermia.  What constitutes a normal temperature is not usually considered in much depth. The range is up to 37.7, noting the time of day variability (6 AM min, 6 PM max), so the upper limit of normal is AM 37.2°C, and PM 37.7°C [1-3].  But in reality temperature varies more than is often supposed for various reasons, see below.  ‘Core’ temperature is taken as being best represent ..read more

Selegiline (deprenyl) is selective for MAO-B at the usual dose of 10 mg daily and may thus be less likely to precipitate ST because 5-HT is metabolised mostly by MAO-A.  There have been reports that are probably ST.  Gitlin’s well-written report demonstrates typical ST features.  This reaction occurred 16 days after ceasing selegiline (50 mg daily- more usual dose is 10 mg daily) when the patient took venlafaxine 37.5 mg x 1 dose. It did not recur on re-challenge one week later [1]. Because the margin between a selective and a non-selective dose is narrow it is difficult to ..read more