Trazodone Citalopram

Waschgler R, Hubmann MR, Conca A, MoU W, Konig P. 2002. Simultaneous quantification of citalopram, clozapine, fluoxetine, norfluoxetine, maprotiline, desmethylmaprotiline and trazodone in human serum by HPLC analysis. Int J Clin Pharmacol Ther 40(12) 554-559. 

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... 

Several LC-MS and LC-MS/MS methods were developed in plasma for only one antidepressant and, sometimes, its major metabolite(s) to perform pharmacokinetic, bioavailability, or bioequivalence studies. Analytical methods developed for these purposes require very low LLOQ values and, usually, narrow linear ranges covering the low range of the therapeutic concentrations are validated. In this context, several methodologies were described for the determination of fluoxetine [94, 95, 98-100], paroxetine [44, 71, 85, 101, 102], venlafaxine [48, 61, 64, 86, 103,104], sertraline [62, 68, 83], citalopram [46, 89] and escitalopram [105], mianserine [106, 107], mirtazapine [42], trazodone [84], nefazodone [51, 81], duloxetine [47, 50, 73], and bupropion [43], Deuterated analogues of the analyte of interest or of other drugs were employed by few authors as IS [43, 61, 73, 81, 85, 99] however, in most of these methods, another antidepressant or other therapeutic drug was used for this purpose. 

Imipramine, desipramine, amitriptyline, nortriptyline, trimipramine, clomipramine, lofepramine, amoxapine, dosulepin, maprotiline, mianserin, setiptiline, trazodone, fluvoxamine, paroxetine, milnacipram, sulpiride, tandspirone, methylpheni-date, melitracen Amitriptyline, imipramine, trimipramine, clomipramine, citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine, reboxetine, viloxazine, doxepin, maprotiline, mianserine, mirtazapine, moclobemide, trazodone, opipramol (and some metabolites)... 

Propotnik M, Waschgler R, Konig P, Moll W, Conca A. Therapeutic drug monitoring of trazodone are there pharmacokinetic interactions involving citalopram and fluoxetine Int J Clin Pharmacol Ther 2004 42 120-4. 

The older tricyclic agents show less than a ten-fold selectivity in inhibiting noradrenaline over that for 5-HT (e.g. desipramine, imipramine, nortriptyline) through amitryptyline. which shows virtually no selectivity, to trazodone, zimelidine and clomipramine, which are somewhat 5-HT selective. The newer Serotonin-Selective Reuptake Inhibitors (SSRIs) show a higher selectivity for inhibition of 5-HT reuptake in the brain, and have a different pharmacology. Examples clinically used include citalopram, fluoxetine, fluvoxamine, nefazodone, paroxetine, sertraline, trazodone and venlafaxine. Experimental agents include 6-nitroquipazine, alaproclate, litoxetine, indatraline and p-CIT. 

Caffeine Citalopram Carvedilol Trazodone Amiodarone Miconazole... 

Hubmann, M.R. Waschgler, R. Moll, W. Conca, A. Konig, R Simultaneous drug monitoring of citalo-pram, clozapine, fluoxetine, maprotiline, and trazodone by HPLC analysis (Abstract 41). Ther.Drug Monit., 1995, 17, 393 [simultaneous citalopram, clozapine, fluoxetine, maprotiline, trazodone LOQ 50 ng/mL]... 

Many noncyclic antidepressants are now available, including trazodone (Desyrel l), nefazodone (Serzone ), fluoxetine (Prozac ), sertraline (Zolotf ), citalopram (Celexa ), escitalopram (Lexapro ), paroxetine (Paxil ), tluvoxamine (Luvox ), venlafaxine (Effexor ), and bupropion (Wellbutrin ). Bupropion is also marketed under the brand name Zyban tor smoking cessation. Mirtazapine (Remeron ), a tetracyclic antidepressant, has recently become available. In general, these drugs are much less toxic than the tricyclic antidepressants (see p 90) and the monoamine oxidase (MAO) inhibitors (p 269), although serious effects such as seizures and hypotension occasionally occur. Noncyclic and tricyclic antidepressants are described in Table 11-7. 

C. Serotonin uptake inhibitors (often called selective serotonin reuptake inhibitors or SSRIs) such as fluoxetine, citalopram, sertraline, paroxetine, flu-voxamine, venlafaxine, and trazodone may interact with each other or with chronic use of an MAO inhibitor (see p 269) to produce the serotonin syndrome (see below and p 21). 

It appears that the plasma levels of trazodone may be increased by fluoxetine due to inhibition of cytochrome P450 isoenzymes by fluoxetine and/or norfluoxetine. Trazodone is a substrate for CYP3A4 and, although fluoxetine is a weak inhibitor, its metabolite norfluoxetine is a moderate inhibitor of this enzyme. vitro data suggest citalopram has little inhib-... 

These cases and studies suggest that the concurrent use of trazodone and fluoxetine can be useful and uneventful but it would seem prudent to monitor the outcome for any evidence of increased adverse effects. Citalopram would not be expected to have a pharmacokinetic interaction. However, the cases with fluoxetine suggest that a pharmacodynamic interaction may be possible, and therefore a degree of caution would be prudent if trazodone is given with any SSRI. 

Acetylsalicylic acid, ibuprofen, fenoprofen, naproxen, diclofenac, ketoprofen in 26 min Fluoxetine, venlafaxine, citalopram, sertraline, paroxetine, clomipramine, trazodone in 17 min... 

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