INTERACTIONS OF ANTIDEPRESSANTS

An overview is presented of interactions of currently frequently used antidepressants with various other drugs. The effects of interactions of tricyclic antidepressants, tetracyclics, monoamine oxidase (MAO) in hibitors, lithium and carbamazepine are comparatively well documented, their pharmcodynamic and pharmacokinetic characteristics extensively researched and well known to the practitioner. These interactions conc ern synergic effects, enzyme inhibition, enzyme induction in the liver , competitive inhibition of absorption and reciprocal effects on the r eceptor. With regard to lithium, problems of renal clearance and circu lation are also important. On the other hand, interactions of reversib le and selective MAO-A inhibitors (RI-MA) and selective serotonin reup take inhibitors (SSRI) with various other drugs are in the process of elucidation. Very threatening interactions are known to be caused by a combination of SSRI and MAO inhibitors (serotonergic syndrome). SSRI and tricyclic antidepressants dispensed concurrently cause an increase in the plasma level of the tricyclic antidepressant. Hence, the pract ioner must become aware of this high responsibility towards the patien t when prescribing even on single drug, which must be selected with th e utmost care.