Tetracyclic antidepressant drugs, drug interactions

No pharmacokinetic interactions or elevations in plasma drug levels of tricyclic or tetracyclic antidepressants when adding or switching to or from milnacipran... 

Apart from these isolated cases the literature seems to be silent about interactions between these antidiabetics and the tricyclic or tetracyclic antidepressants. Bearing in mind the length of time these groups of drugs have been available, the risk of a clinically important interaction would seem to be very small. 

Gundert-Remy U, Amann E, Hildebrandt R, Weber E. Lack of interaction between the tetracyclic antidepressant maprotiline and the centrally acting antihypertensive drug clcmidine. EurJClm Pharmacol (1983) 25,595-9. 

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