Phenelzine Buspirone

Social anxiety disorder Escitalopram Fluvoxamine Paroxetine Sertraline Venlafaxine XR Citalopram Clonazepam Buspirone Gabapentin Miitazapine Phenelzine Pregabalin... 

Clinically important, potentially hazardous interactions with aprepitant, astemizole, buspirone, dasatinib, eszopiclone, fesoterodine, isocarboxazid, ivabradine, ixabepilone, lapatinib, MAO inhibitors, phenelzine, pimozide, rimonabant, selegiline, sibutramine, solifenacin, St John s wort, sumatriptan, temsirolimus, tolvaptan, tramadol, tranylcypromine, trazodone... 

For panic disorder, tricychc antidepressants and MAO inhibitors, as well as high-potency benzodiazepines (notably alprazolam, clonazepam, and lorazepam) (see Chapter 16), are effective in blocking the autonomic expression of panic itself, thereby facilitating a comprehensive rehabilitation program. Imipramine and phenelzine are well-studied antidepressants for panic disorder. SSRIs also may be effective, but /3 adrenergic receptor antagonists, buspirone, and low-potency benzodiazepines usually are not, and bupropion can worsen anxiety. 

Augmentation is called for when there is partial or non-response to the above approaches. Combinations of SSRIs with buspirone, clonazepam, clonidine, inositol, lithium, pindolol, olanzapine, risperidone, trazodone, tryptophan, and venlafaxine have been reported, with limited benefit. To date, only two augmenting agents have been found to be effective in double-blind studies risperidone and pindolol. Augmentation of SSRIs with clomipramine (or vice versa) is a common practice in non-responders however, this combination may lead to a substantial increase in the level of tricyclics in the blood and/or increase the risk of serotonin syndrome. Phenelzine may be helpful in symmetry-related or other atypical obsessions. Electroconvulsive therapy (ECT) should be reserved for severely depressed and suicidal OCD patients. Neurosurgery is the last resort current operations include anterior cingulotomy, anterior capsulotomy, subcaudate tractotomy, and limbic leucotomy. The outcome of such operations is questionable. 

Elevated blood pressure has been reported in four patients taking buspirone and either phenelzine or tranylcypromine. Buspirone may have contributed to a case of the serotonin syndrome in a patient who overdosed on moclobemide and clomipramine. 

Four cases of significant blood pressure elevation, which occurred during the use of buspirone and either phenelzine or tranylcypromine, have been reported to the FDA s Spontaneous Reporting System. One patient was a 75-year-old woman and the other 3 patients were men aged between 30 and 42 years. The report does not say how much the blood pressure rose, or how quickly, and no other details are given. On the basis of this rather sparse information the manufacturers of buspirone " recommend that it should not be used concurrently with an MAOI. 

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