Antidepressants drug interactions and

Riesenman C Antidepressant drug interactions and the cytochrome P450 system A critical appraisal. Pharmacotherapy 1995 15(6 Pt 2) 84S. 

Ereshefsky L, Riesenman C, Lam YW. Antidepressant drug interactions and the cytochrome P450 system—the role of cytochrome P4502D6. Clin Pharmacokinet 1995 29(suppl 1) 10-19. 

Neuroleptic and antidepressant drugs interact with a number of different receptors in the brain, which may partly explain their PK-PD relationships. Figure 9 shows the bell shaped concentration-response relationship for the antidepressant drug nortriptyline. 

All SSRIs appear to be equally efficacious for the treatment of major depression and, overall, present similar side effect profiles. However, they have some differences, including elimination half-lives, profiles of drug interactions, and the antidepressant activity of their metabolites (e.g., Leonard et ah, 1997 Findling et ah, 1999 Axelson et ah, 2000 a,b). 

Our treatment of antidepressants in this chapter is at the conceptual level and not at the pragmatic level. The reader should consult standard drug handbooks for details of doses, side effects, drug interactions, and other issues relevant to the prescribing of these drugs in clinical practice. 

Lantz MS, Buchalter E, Giambanco V. St. John s Wort and antidepressant drug interactions in the elderly. J Geriatr Psychiatry Neurol 1999 12 7-10. 

The uses, drug interactions, and adverse effects of the monoamine oxidase inhibitor tricyclic, selective serotonin reuptake inhibitor, and heterocyclic antidepressants are discussed. 

Ritter JL, Alexander B, Retrospective study of selegiline-antidepressant drug interactic s and a review ofthe literature, Am Clin Psychiatry (1997) 9,7-13. 

Discuss the uses, general drug actions, general adverse reactions, contraindications, precautions, and interactions of the antidepressant drugs. 

The separation was carried out on a bonded phase LC-PCN column carrying cyanopropylmethyl moieties on the surface. Thus, in contrast to the extraction process, which appears to be based on ionic interactions with the weak ion exchange material, the LC separation appears to be based on a mixture of interactions. There will be dispersive interactions of the drugs with the hydrocarbon chains of the bonded moiety and also weakly polar interactions with the cyano group. It is seen that the extraction procedures are very efficient and all the tricyclic antidepressant drugs are eluted discretely. 

Differentiate antidepressants according to pharmacologic properties, adverse-effect profiles, pharmacokinetic profiles, drug interaction profiles, and dosing features. 

The major drug interactions of antidepressants are shown in Table 35—6.9,19,30 Antidepressants cause both pharmacodynamic (e.g., additive pharmacologic effects) and pharmacokinetic (e.g., changes in drug levels) interactions with other medications. 

Several antidepressants, including most of the SSRIs, nefa-zodone, and duloxetine, are known to inhibit various cytochrome P-450 isoenzymes, thereby elevating plasma levels of substrates for those isoenzymes and thus potentially leading to increased adverse effects or toxicity of those drugs. The propensity to cause these drug interactions will vary with the particular antidepressant and the precise isoenzyme9,19,30 (Table 35-6). 

Each antidepressant has a response rate of approximately 60% to 80%, and no antidepressant medication or class has been reliably shown to be more efficacious than another 22 MAOIs may be the most effective therapy for atypical depression, but MAOI use continues to wane because of problematic adverse effects, dietary restrictions, and possibility of fatal drug interactions.22,28 There is some evidence that dual-action antidepressants, such as TCAs and SNRIs, may be more effective for inpatients with severe depression than are the single-action drugs such as SSRIs,22,28 but the more general assertion that multiple mechanisms of action confer efficacy advantages is quite controversial.33... 

Drug Interactions Carbamazepine induces the hepatic metabolism of many drugs, including other antiepileptic drugs, antipsychotics, some antidepressants, oral contraceptives, and... 

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