Barbiturates Tricyclic antidepressants

Avoid taking barbiturates, tricyclic antidepressants, antihistamines, central nervous system depressants, and OTC cold medications with MAOIs. 

Patients occasionally respond favorably to clonazepam or carbamazepine, but diazepam, barbiturates, tricyclic antidepressants, phenytoin, and cholinergic agonists (such as deanol) are usually not helpful. 

Besides ampicillin there are numerous other drugs which cause maculopapular eruptions. The drugs most frequently mentioned are other penicillins, streptomycin, rifampicin, sulfonamides, pyrazolidine derivatives (phenylbutazone), pyrazolones, barbiturates, tricyclic antidepressants, hydantoin derivatives, indomethacin, quinine, and meprobamate (Kauppinen 1972 Korting 1972 Louis and Schulz 1973 Schuppli 1972 Thiers et al. 1964). 

Fishbein (1983) reviewed TLC studies on certain classes of pharmaceuticals and on drugs of abuse and abused drugs. He considered the significant TLC studies on barbiturates, tricyclic antidepressants, benzodiazepines, antiarrhythmic drugs, phenacetin and acetaminophen, and several miscellaneous drugs. This chapter considers the aforementioned drugs along with several others. 

If excessive noradrenergic transmission is a causal factor in anxiety, then it would be predicted that a lesion of central noradrenergic neurons would have an anti-anxiety effect in behavioural models of this condition. Unfortunately, the behavioural effects of such lesions are notoriously inconsistent and there are many reports of negative findings (e.g. Salmon, Tsaltas and Gray 1989). One study has even shown that a lesion of central noradrenergic neurons, induced by the selective neurotoxin, DSP-4, abolishes the anti-anxiety effects of tricyclic antidepressants and MAO inhibitors, but not those of the benzodiazepine, alprazolam, or the barbiturate, phenobarbitone (Fontana,... 

Opioids, benzodiazepines, barbiturates, corticosteroids, dopamine agonists (e.g., amantadine, bromocriptine, levodopa, pergolide, pramipexole, ropinirole), H2-receptor antagonists, anticholinergics (e.g., diphenhydramine, trihexylphenidyl), P-adrenergic blockers, clonidine, methyldopa, carbamazepine, phenytoin, baclofen, cyclobenzaprine, lithium, antidepressants (e.g., tricyclic antidepressants, selective serotonin reuptake inhibitors), and interleukin-2... 

Drug withdrawal reactions - tricyclic antidepressants, monoamine oxidase inhibitors, benzodiazepines, barbiturates, alcohol, opioids. 

Coadministration of beta-blockers can potentiate rebound hypertension upon discontinuation of medications, and it is therefore recommended that the beta-blocker be withdrawn before the tt2 agonist (Physicians Desk Reference, 2001). Tricyclic antidepressants may also produce changes in sinus node and AV conduction, and it is recommended that they be used cautiously in combination with tt2 agonists (Physicians Desk Reference, 2001). However, in child psychiatric practice, there has been debate about whether there are adverse interactions related to concomitant use of tricyclics and tt2 agonists. Finally, the tt2 agonists may potentiate the effects of CNS depressants (e.g., barbiturates) or other medications that produce sedation, so lower doses of each may be warranted. 

The respiratory depression induced by morphine can add to that of alcohol, barbiturates, benzodiazepines (such as Valium), and even with antihistamines taken for allergies. Combined effects of these drugs with morphine can dangerously compromise breathing. Tricyclic antidepressants can hamper the metabolism of morphine. 

Tricyclic antidepressants + barbiturates, carbamazepine —> increased metabolism of the tricyclic due to enzyme induction leading to a reduced antidepressant effect. 

Toxicants may have three effects on pulse rate bradycardia (decreased rate), tachycardia (increased rate), and arrhythmia (irregular pulse). Alcohols may cause either bradycardia or tachycardia. Amphetamines, belladonna alkaloids, cocaine, and tricyclic antidepressants (see imi-primine hydrochloride in Figure 6.12) may cause either tachycardia or arrhythmia. Toxic doses of digitalis may result in bradycardia or arrhythmia. The pulse rate is decreased by toxic exposure to carbamates, organophosphates, local anesthetics, barbiturates, clonidine, muscaric mushroom toxins, and opiates. In addition to the substances mentioned above, those that cause arrhythmia are arsenic, caffeine, belladonna alkaloids, phenothizine, theophylline, and some kinds of solvents. 

Amphetamines and cocaine (Figure 6.11), tricyclic antidepressants (see imiprimine hydrochloride in Figure 6.12), phenylcyclidines, and belladonna alkaloids at toxic levels increase blood pressure. Overdoses of antihypertensive agents decrease blood pressure, as do toxic doses of opiates, barbiturates, iron, nitrite, cyanide, and mushroom toxins. 

Anesthetics, antihistamines, barbiturates, benzodiazepines, chloral hydrate, meprobamate, narcotics, phenothiazines, tricyclic antidepressants Phenothiazines Diazepam... 

Therefore some advertisements emphasised the sedative action of tricyclic antidepressants. Amitriptyline, for example, was frequently recommended for its sedative action. It was described in one advert as having intrinsic tranquillising properties and additional sedative action which relieves insomnia, agitation and anxiety (Tryptizol advertisement 1964). Drinamyl, the combination of amphetamine and a barbiturate... 

Phenothiazines and related drugs, e.g., chlorpromazine (Largactil/ Thorazine). Some tricyclic antidepressants, e.g., amitriptyline Dibenzodiazepine derivatives and thienobenzodiazepines, e.g., clozapine, olanzapine Benzodiazepines, e.g., diazepam (Valium), nitrezepam (Librium) and lorazepam Barbiturates Opiates... 

Some of the tricyclic antidepressants and barbiturates are probably more lethal than BZs taken alone. But when BZs are combined with other drugs, such as alcohol, their lethality is increased. Overall, the BZs account for many more suicides than most physicians probably realize. 

Anesthetics Antihistamines Antiparkinsonian agents Barbiturates Benzodiazepines Chloral hydrate Hypoglycemic agents Opiate analgesics Thyroid extract Tricyclic antidepressants... 

Opioid analgesics Tricyclic antidepressants Sedating antihistamines Benzodiazepines and other hypnotics Barbiturates... 

All the major oxidative mechanisms can be illustrated by considering the metabolism of the barbiturates, benzodiazepines, amphetamines, tricyclic antidepressants, phenothiazines, and opiates. 

Thermoregulation Poor temperature-regulating mechanisms 1 shivering 1 metabolic rate i vasconstriction i thirst response i subjective awareness of temperature Medications affecting awareness, mobility, muscular activity, vasoconstrictor mechanisms CNS medications Phenothiazines Barbiturates Benzodiazepines Tricyclic antidepressants Narcotics Alcohol... 

Clinically important, potentially hazardous interactions with alcohol, barbiturates, hypnotics, narcotic analgesics, sedatives, tranquilizers, tricyclic antidepressants... 

Clinically important, potentially hazardous interactions with acyclovir, alcohol, amphetamines, barbiturates, CNS depressants, fluoxetine, furazolidone, general anesthetics, glycopyrrolate, glycopyrronium, isocarboxazid, linezolid, lithium, MAO inhibitors, moclobemide, phenelzine, phenobarbital, phenothiazines, rasagiline, ritonavir, selegiline, sibutramine, SSRIs, tranquilizers, tranylcypromine, tricyclic antidepressants, val acyclovir... 

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