Thioridazine Citalopram

OFFICIAL NAMES Amitriptyline (Elavil), amoxapine (Asendin), bupropion (Wellbutrin), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), fluoxetine (Prozac), imipramine (Norfranil, Tofranil), isocarboxazid (Marplan), maprotiline (Ludiomil), mirtazapine (Remeron), nefazodone (Serzone), nortriptyline (Aventyl, Pamelor), paroxetine (Paxil), phenelzine (Nardil), protriptyline (Vivactil), sertraline (Zoloft), thioridazine (Mellaril), tranylcypromine (Parnate), trazodone (Desyrel), trimipramine (Sur-montil), venlafaxine (Effexor) the herb St. John s wort (Hypericum perforatum) is sold over-the-counter without prescription STREET NAMES Happy pills... 

CYP450 2D6 inhibitors including paroxetine, fluoxetine, duloxetine, bupropion, sertraline, citalopram, and others can raise thioridazine to dangerous levels... 

Citalopram does not interfere with the metabolism of APDs. At a dose of 40 mg/day, citalopram caused no significant changes in plasma concentrations of chlorpromazine, clozapine, haloperidol, perphenazine, thioridazine, or zuclopenthixol. Anecdotal data suggest that citalopram may increase the serum levels of levomepromazine. 

A study in schizophrenic patients found that over a 12-week period the serum levels of thioridazine were not significantly altered by citalopram 40 mg daily. ... 

On the whole significant interactions between the antipsychotics and SSRIs appear rare (although see thioridazine, below). The combination can be useful and so the isolated cases of extrapyramidal adverse effects should not prevent concurrent use. However, if extrapyramidal effects become troublesome bear this interaction in mind as a possible cause. The significance of the rise in haloperidol levels caused by fluoxetine and fluvoxamine is unclear, be aware that haloperidol adverse effects may be increased in some patients and consider reducing the haloperidol dose if problems occur. The rise in perphenazine levels caused by paroxetine seems to result in a greater number of more serious adverse effects and so consideration should be given to reducing the dose of perphenazine if paroxetine is started. Citalopram may be a suitable alternative as it does not appear to affect perphenazine levels. 

---

See also in sourсe #XX -- [ ]

---