Tetrabenazine MAOIs

MAOIs TETRABENAZINE Risk of confusion and agitation Uncertain although tetrabenazine depletes norepinephrine, if it is started on a patient who is already taking MAOIs it may stimulate the release of accumulated neurotransmitter. This would not be expected if a patient started MAOI while already taking tetrabenazine Tetrabenazine may cause depression so should be used with caution in patients with depression. If necessary, consider using an alternative antidepressant or start an MAOI after tetrabenazine has been established... 

Central excitation and possibly hypertension can occur if rauwolfia alkaloids are given to patients already taking an MAOI, but is less likely if the rauwolfia alkaloid is given first. Theoretically additive blood-pressure lowering effects are also a possibility. The use of drugs that have the potential to cause depression, such as the rauwolfia alkaloids or tetrabenazine, is generally contraindicated in patients needing treatment for depression. 

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