Isoniazid SSRIs

Drugs that can increase carbamazepine serum levels include cimetidine, danazol, diltiazem, erythromycin, felbamate, clarithromycin, fluoxetine, isoniazid, niacinamide, propoxyphene, ketaconazole, itraconazole, verapamil, valproate, troleandomycin, loratadine, nicotinamide, tricyclic antidepressants, SSRIs, nefazodone, protease inhibitors. 

Antidepressant drugs of various classes (tricyclics, MAO inhibitors, SSRIs) have broad efficacy in generalized anxiety and in panic disorder, but SSRIs are now the treatments of choice (2,3). Selegiline has been used to treat Parkinson s disease. Other drugs that have MAO inhibitory activity, but are not used as such, include deb-risoquine, linezolid, and isoniazid. 

Omeprazole, like cimetidine, can impair benzodiazepine metabolism and lead to adverse effects (SEDA-18, 43). Other drugs, including antibiotics (erythromycin, chloramphenicol, isoniazid), antifungal drugs (ketoconazole, itraconazole, and analogues), some SSRIs (fluoxetine, paroxetine), other antidepressants (nefazodone), protease inhibitors (saquinavir), opioids (fentanyl), calcium channel blockers (diltiazem, verapamil), and disulfiram also compete for hepatic oxidative pathways that metabolize most benzodiazepines, as well as zolpidem, zopiclone, and buspirone (SEDA-22,39) (SEDA-22,41). 

Isoniazid No important interaction appears to occur between isoniazid and the SSRIs or nefazo-done. However, adverse reactions have been seen... 

C9 Amiodarone, chloramphenicol, cimetidine, isoniazid, metronidazole, SSRIs, zafirlukast Barbiturates, chloramphenicol, doxorubicin, ibuprofen, phenytoin, chlorpromazine, steroids, tolbutamide, (S>warfarin... 

A retrospective review of HIV-positive patients who were taking either an SSRI, isoniazid, or both, found that the rate of discontinuation of the SSRI was higher in those also taking isoniazid (7 of 10 patients) than in the group of patients taking an SSRI alone (2 of 14). It is unclear why this rate was increased little mention is made of the influence of other drugs or medical conditions. ... 

Direct information about the concurrent use of isoniazid and SSRIs seems to be limited, but the case reports cited here would suggest that the combination of isoniazid and these SSRIs is normally without problems. However, also be aware that one report suggests the possibility of an inerease in adverse effects with the combination of SSRIs and isoniazid. In fheory isoniazid could interact with the SSRIs because it has some weak MAO inhibitory activity. However, isoniazid rarely interacts like the MAOIs. This is because isoniazid seems to lack activity on mitochondrial MAO even though it has activity on plasma MAO. Therefore no adverse MAOI/SSRI interaction would usually be expected. 

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