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Antidepressants (cont.)

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Selective serotonin reuptake inhibitors (SSRIs) interactions

Selective serotonin reuptake inhibitors (SSRIs) should not be combined with other drugs that increase brain serotonin levels [for example, MAOIs, TCAs, sumatriptan (Imitrex), linezolid (Zyvox), St John's Wort, amphetamines] because there is a risk of dangerous adverse effects. The risk of gastrointestinal bleeding may be increased when SSRIs are combined with nonsteroidal antiinflammatory drugs (NSAIDs).

Monoamine oxidase inhibitors (MAOIs) interactions

Monoamine oxidase inhibitors (MAOIs) should not be combined with other antidepressants or other drugs that increase serotonin levels [for example, amphetamines, linezolid (Zyvox), St. Johns Wort, sumatriptan (Imitrex)]. Such combinations cause excessive serotonin levels in the brain, which may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. Administration of MAOIs and other antidepressants or drugs that elevate serotonin should be separated by 14 days. Administration of MAOIs with epinephrine, norepinephrine, phenylephrine, pseudoephedrine, and dopamine may lead to hypertensive crisis. MAOIs interact with tyramine containing foods, resulting in a hypertensive crisis.



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