Phenelzine Pethidine

Dmg-induced serotonin syndrome is generally mild and resolves when the offending drugs are stopped. However, it can be severe and deaths have occurred. A large number of drugs have been implicated including tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), selective serotonin re-uptake inhibitors (SSRIs), pethidine, lithium, and dextromethorphan. The most severe type of reaction has occurred with the combination of selective serotonin re-uptake inhibitors and monoamine oxidase inhibitors. Both non-selective MAOIs such as phenelzine and selective MAOIs such as moclobemide and selegiline have been implicated. 

Pethidine see Meperidine Peyote see Mescaline Phendimetrazine see Diet pills Phenelzine see Antidepressants Phenobarbital see Barbiturates Phentermine see Diet pills... 

Problems can also occur if a drug taken to inhibit a metabolic reaction is taken with a drug normally metabolized by that reaction. The latter would then be more slowly metabolized, increasing the risk of an overdose. For example, the antidepressant drug phenelzine (Fig. 8.4) inhibits the metabolism of amines and should not be taken with drugs such as amphetamines or pethidine. Even amine-rich foods can lead to adverse effects, implying that cheese and wine parties are hardly the way to cheer the victim of depression. 

Metabolic inactivation, whether taking place in the e,r. or at other sites, is often accidentally inhibited by other drugs. Thus many patients have died as a result of the simultaneous administration of an inhibitor of monamine oxidase (an enzyme present in mitochondria) and an amine drug which is not toxic on its own. Thus the inhibitor phenelzine (9.36) (phenylethyl-hydrazine) has caused deaths after usually safe doses of amphetamine, pethidine, nortriptyline, or amitriptyline, or after the patient has consumed amine-rich food such as cheese, red wine, meat-extract, yeast-extract, or broad beans. These are examples of unfortunate synergism, but many favourable examples are known, examples of which will now be given. 

---