Tranylcypromine Fluoxetine

The answer is b. (Katzung, p 1130J Fatalities have been reported when fluoxetine and MAO inhibitors (MAOIs) such as tranylcypromine have been given simultaneously The MAOLs should be stopped at least two weeks before the administration of fluoxetine or paroxetine. The mechanism of this interaction is under investigation... 

Several compounds affecting various 5-HT functional parameters (uptake inhibition (fluoxetine), metabolism (tranylcypromine) or synthesis (5-OH tryptophan, 5-HTP)) had no effect on subemetic doses of cisplatin [110]. In fact, tranylcypromine and 5-HTP antagonized emesis of cisplatin. Thus these results would favour an inhibitory role of 5-HT instead of emetogenic. It is conceivable that an excess of 5-HT may desensitize 5-HT3 receptors that may result in a reduced sensitivity to emetogenic stimuli. 

There are four classes of antidepressants tricyclic antidepressants (imipramine, trimipramine, amitriptyline, doxepin, desipramine, protriptyline, nortriptyline, amoxapine, maprotiline) monoaminooxidase (MAO) inhibitors (phenelzine, isocarboxazid, tranylcypromine) second-generation antidepressants or atypical antidepressants, which are a chemically dissimilar group of recently proposed drugs (bupropion, trazodone, fluoxetine) and amphetamines and other stimulators of the CNS (dextroamphetamine, methylphenidate). 

Due to the frequent unwanted effects and, in case of tranylcypromine, the numerous and dangerous interactions MAO-inhibitors are more and more replaced by the much less problematic SSRIs. Compounds belonging to this group are citalopram, escitalopram, fluoxetine, paroxetine and sertraline. They are used clinically in the therapy of depression, bulimia and obsessive-compulsive disorders. All SSRIs show a slow onset of action (1-2 weeks). They may induce insomnia and weight loss. The antidepressant ven-lafaxine inhibits both, serotonin and noradrenaline re-uptake and might therefore additionally induce hypertension. 

Ravindran AV, Bialik RJ, Lapierre YD Primary early onset dysthymia, biochemical correlates of the therapeutic response to fluoxetine, 11 urinary metabolites of serotonin, norepinephrine and melatonin. J Affect Disord 31 119-123, 1994d Razani J, White KL, White J, et al The safety and efficacy of combined amitryptiline and tranylcypromine antidepressant treatment—a controlled trial. Arch Gen Psychiatry 40 657-661, 1983... 

Results of crossover studies indicate that lithium is efficacious in treating acute depression in bipolar subjects unequivocally (36%, 29/80) and partially (43%. 34/80). respectively (Xomberg and Pope, 1993 Keck and McElroy, 2002). Various antidepressants have shown variable rates of efficacy in the treatment of acute bipolar depression, i.e. desipramine (50%), maprotiline (67%), imipra-mine (40 60%), tranylcypromine (87%), moclobemide (53%) and fluoxetine (60%) (Keck and McElroy, 2002). Among the anticonvulsants, valproic add and lamotrigine appear to have some potential efficacy in the treatment of acute bipolar depression (Calabrese et al., 1992, 1999 Fatemi et al., 1997). 

OFFICIAL NAMES Amitriptyline (Elavil), amoxapine (Asendin), bupropion (Wellbutrin), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), fluoxetine (Prozac), imipramine (Norfranil, Tofranil), isocarboxazid (Marplan), maprotiline (Ludiomil), mirtazapine (Remeron), nefazodone (Serzone), nortriptyline (Aventyl, Pamelor), paroxetine (Paxil), phenelzine (Nardil), protriptyline (Vivactil), sertraline (Zoloft), thioridazine (Mellaril), tranylcypromine (Parnate), trazodone (Desyrel), trimipramine (Sur-montil), venlafaxine (Effexor) the herb St. John s wort (Hypericum perforatum) is sold over-the-counter without prescription STREET NAMES Happy pills... 

The correct answer = B The tricyclic antidepressants and especially imipramine are effective in this condition because it contracts the internal sphincter of the bladder. Fluoxetine and trazodone act at serotonin receptors and have no effect on bladder function. Tranylcypromine is an MAO inhibitor with serious side effects. 

Clinically important, potentially hazardous interactions with fluoxetine, fluvoxamine, MAO inhibitors, paroxetine, phenelzine, sertraline, tranylcypromine... 

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... 

Clinically important, potentially hazardous interactions with desvenlafaxine, dextromethorphan, dihydroergotamine, ephedra, ergot, fluoxetine, fluvoxamine, isocarboxazid, linezolid, lithium, MAO inhibitors, meperidine, methysergide, naratriptan, nefazodone, paroxetine, phenelzine, rizatriptan, sertraline, sumatriptan, tranylcypromine, tryptophan, venlafaxine, verapamil, zolmitriptan, zuclopenthixol... 

Cimetidine, fluconazole, fluoxetine, fluoxamine, ketoconazole, (iS)-mephenytoin, omeprazole, tranylcypromine... 

DA agonists levodopa, bromocriptine, ropinirole, pramipexole, selegiline AAAD inhibitor carbidopa M-blockers benztropine, trihexiphenidyl MAOIs phenelzine, tranylcypromine TCAs amitriptyline, imipramine, clomipramine SSRIs fluoxetine, paroxetine, sertraline Others bupropion, mirtazapine, nefazodone, trazodone... 

Extracted amoxapine, brompheniramine, chlorpheniramine, chlorpromazine, clomipramine, c5q)roheptadine, dsipramine, diphenhydramine, dothiepin, doxepin, fluoxetine, hal-operidol, imipramine, loxapine, maprotihne, meperidine, mesoridazine, methadone, metoclopramide, mianserin, moclobemide, nomifensine, nordoxepin, norfluoxetine, norpropoxyphene, northiaden, nortriptyline, pentobarbital, pheniramine, propojgrphene, propranolol, protriptyline, quinidine, quinine, sulforidazine, thioridazine, thiothixene, tranylcypromine, trazodone, trihe q)henidyl, triprolidine Nonintetfering dextromethorphan, norphetidine, pheno benzamine, prochlorperazine, trifluoperazine... 

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