Sibutramine SSRIs

If patient is taking any agent that can inhibit serotonin reuptake (e.g., SSRIs, sibutramine, tramadol, milnacipran, duloxetine, venlafaxine, clomipramine, etc.)... 

Antidepressants MAOIs, TCAs, SSRIs, SNRIs, mirtazapine, venlafaxine Amphetamines, phentermine, methylphenidate, sibutramine... 

For patients with moderately severe BED, treatment with cognitive behaviour therapy combined with an antidepressant of the SSRI type is the treatment of choice, If this proves ineffective, preliminary results suggest that possible alternative drugs, including venlafaxine, sibutramine and topiramate are potentially useful. Their definitive place in the treatment of BED awaits the outcome of further research. 

Clinically important, potentially hazardous interactions with acyclovir, alcohol, amphetamines, barbiturates, CNS depressants, fluoxetine, furazolidone, general anesthetics, glycopyrrolate, glycopyrronium, isocarboxazid, linezolid, lithium, MAO inhibitors, moclobemide, phenelzine, phenobarbital, phenothiazines, rasagiline, ritonavir, selegiline, sibutramine, SSRIs, tranquilizers, tranylcypromine, tricyclic antidepressants, val acyclovir... 

Sibutramine is not an antidepressant. Caution is used when prescribing sibutramine to a client taking an SSRI or MAO inhibitor antidepressant because a potentially life-threatening serotonin syndrome can occur. 

There are no reports of adverse reactions between sibutramine and the MAOIs. However, sibutramine inhibits serotonin reuptake, and because the serious serotonin syndrome can occur when MAOIs and SSRIs are used together, the manufacturers warn that concurrent use of sibutramine and MAOIs is contraindicated. They say that 14 days should elapse between stopping either drug and starting the other. The US manufacturers included selegUine in this warning. ... 

Because sibutramine inhibits serotonin uptake, and because the serious serotonin syndrome has been seen when serotonergic drugs were taken with SSRIs, the manufacturers say that sibutramine should not be taken with any serotonergic drugs. They name dextromethorphan, dihydroergot-amine, fentanyl, pentazocine, pethidine (meperidine), SSRIs, sumatriptan, and tryptophan. Possible cases have been reported for sibutramine and SSMs , (below).The US manufacturers also include lithium in their list. Note that this list is not exhaustive (see MAOIs under (d) above) and a case of the serotonin syndrome has been seen when venla-faxine was given with sibutramine. ... 

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