Risperidone maprotiline

D6 Tricyclic antidepressants (TCAs), benztropine, perphenazine, clozapine, haloperidol, codeine/oxycodone, risperidone, class Ic antiarrhythmics, 3 blockers, trazodone, paroxetine, maprotiline, amoxapine, duloxetine, mirtazapine (partly), venlafaxine, bupropion Fluoxetine, paroxetine, duloxetine, hydroxybupropion, methadone, cimetidine, haloperidol, quinidine, ritonavir Phenobarbital, rifampin... 

In three patients, plasma concentrations of maprotiline were increased by concomitant treatment with the atypical antipsychotic drug, risperidone (26). The data suggest that risperidone is a modest inhibitor of CYP2D6 and should therefore be used with caution in combination with drugs such as maprotiline, where increased plasma concentrations have the potential to cause serious toxicity. 

In three patients, maprotiline plasma concentrations increased when risperidone was added (28). The rise was explained by inhibition of CYP2D6, by which maprotiline is mainly metabolized. 

Normann C, Lieb K, Walden J. Increased plasma concentration of maprotiline by coadministration of risperidone. J Chn Psychopharmacol 2002 22(l) 92-4. 

Risperidone appears to increase the plasma levels of maprotiline. 

Gradual increases in maprotiline levels over 6 to 7 weeks during concurrent risperidone therapy have been found in 2 other patients. One of the patients was also taking nortriptyline, but its levels were unaltered. Maprotiline is mainly metabolised by the cytochrome P450 isoenzyme CYP2D6. The increased levels of maprotiline may be due to an inhibition of CYP2D6-mediated metabolism by risperidone. This interaction is... 

---