Dexamfetamine Citalopram

A man taking long-term dexamfetamine had two episodes of serotonin syndrome while taking first venlafaxine and later citalopram (120). 

Dexamfetamine was restarted 3 days later and citalopram was started a few days later. Two weeks later he reported similar symptoms and stopped taking citalopram. He was successfully treated again with cyproheptadine. 

INDIRECT SSRIs 1. Case report of serotonin syndrome when dexamfetamine was co-administered with citalopram 2. Case reports of psychiatric disturbances when methylphenidate was given with sertraline and phenylpropanolamine co-adminis-tered with phenylpropanolamine 1. Uncertain postulated that it is an additive effect of the inhibition of serotonin reuptake by citalopram with the release of serotonin by venlafaxine 2. Uncertain 1. Avoid co-administration of dexamfetamine and citalopram 2. Warn patients to watch for early signs such as anxiety... 

Isolated reports describe delirium in one patient and a seizure in another when methylphenidate was taken with sertraline. Schizophrenia and symptoms of amfetamine toxicity have also been reported in two patients taking amfetamine and fluoxetine. There is an isolated report of the serotonin syndrome associated with concurrent citalopram and dexamfetamine and another associated with sertraline and etilefrine. There is also a report of adverse effects associated with fluoxetine and phenylpropanolamine. 

Dexamfetamine. A patient who experienced the serotonin syndrome with concurrent venlafaxine , (p.l214) and dexamfetamine had a second episode when citalopram was given with the dexamfetamine. ... 

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