Risperidone Mirtazapine

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... 

During the course of a study of the salts formed by saccharin with quinine, haloperidol, mirtazapine, pseudoephedrine, lamivudine, risperidone, sertraline, venlafaxine, zolpidem, and amlodipine, a 1 1 cocrystal of saccharin and piroxicam was detected [68]. In the crystal structure, the asymmetric unit was found to consist of one saccharin molecule and one zwitterionic piroxicam molecule that were linked by two sets of N—H O hydrogen bonds. The piroxicam-saccharin synthons were in turn linked through bridging C—H O hydrogen bonds. Interestingly, the drug substance solubility out of the cocrystal was found to be comparable to that of the marketed piroxicam product. 

Antidepressants mirtazapine, nefazodone, sertraline Neuroleptics thioridazine, haloperidol, clozapine, quetiapine, risperidone, sertindole, ziprasidone Mood stabilizers carbamazepine, gabapentin, lamotrigine... 

I Liquid preparations (e.g. risperidone, fluoxetine) and oral dispersible tablets (e.g. olanzapine, risperidone, mirtazapine) are aimed at ensuring administration/improving compliance. They generally have minimal effects on absorption. 

Zoccali R, Muscatello MR, La Tcwe D, Ivkilara G, Canale A, Crucitti D, D Arrigo C, Spina E. Lack of a pharmacokinetic interaction between mirtazapine and the newer antipsychotics clozapine, risperidone and olanzapine in patients with chronic schizoii enia. Pharm Res (2003) 48,411-14. 

No pharmacokinetic interaction normally occurs between risperidone and amitriptyline or mirtazapine, but extrapyramidal reactions have been reported in one patient taking amitriptyline with risperidone. 

A study in 8 patients taking risperidone in doses ranging from 3 to 8 mg daily found no significant change in the pharmacokinetics of risperidone and its metabolite, 9-hydroxyrisperidone when they were also given mirtazapine 30 mg daily. ... 

Limited evidence suggests that risperidone does not appear to affect mirtazapine pharmacokinetics. Mirtazapine does not appear to interact to a ciinicaiiy reievant extent with clozapine, olanzapine or risperidone. 

A pilot study in 6 psychiatric patients taking risperidone 1 to 3 mg twice a day for 1 to 4 weeks followed by 2 to 4 weeks of combined treatment with mirtazapine 15 to 30 mg at night, found that mirtazapine did not affect the plasma levels of risperidone or its 9-hydroxy metabolite. Data from another patient suggest that giving risperidone with mirtazapine does not result in clinically relevant changes in the plasma levels of mirtazapine. Concurrent use did not appear to increase the incidence of adverse effects, but the number of patients was limited. ... 

Another study in 24 schizophrenic patients investigated the effect of adding mirtazapine 30 mg at bedtime, for 6 weeks, to treatment with clozapine (9 patients), risperidone (8), or olanzapine (7). Mirtazapine had a negligible effect on the metabolism of all three drugs and the combination was well tolerated. ... 

Thieme, D. Sachs, H. Improved screening capabilities in forensic toxicology by application of liquid chromatography-tandem mass spectrometry, Anal.ChimActa, 2003, 492, 171-186. [hair LC-MS alprazolam dothiepin piritramide cocaine lorazepam lormetazepam clonazepam flimitrazepam bromazepam midazolam flurazepam nitrazepam temazepam medazepam nordazepam diazepam methylclonazepam triazolam oxazepam haloperidol benperidol sulpiride amisulpride mirtazapine citalopram olanzapine paroxetine fluoxetine sertraline zopiclone zolpidem risperidone quetiapine fentanyl pipamperone meperidine buprenorphine propoxyphene pentazocine phenazocine EDDP ... 

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