Monoamine oxidase inhibitors dosage

The risk of serotonin syndrome may be increased shortly after dosage increases of SSRIs or when drug interactions increase serotonin activity. Concomitant or proximal use of SSRIs, tricyclic antidepressants, or monoamine oxidase inhibitors may cause serotonin syndrome. Further, the addition of certain drugs, such as tryptophan, dextromethorphan, cocaine, or sympathomimetics, to SSRI therapy may increase the risk of developing serotonin syndrome." ... 

No dosage adjustment is required in patients with mild to moderate renal impairment however, escitalopram should be used with caution in patients with severe renal impairment. Escitalopram is contraindicated in combination with irreversible monoamine oxidase inhibitors (MAOis), and a period of at least 2 weeks should be allowed between discontinuation of escitaiopram and commencement of an irreversible MAOi and vice versa. Escitaiopram appears to be a well-tolerated and effective antidepressant. 

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