Trimipramine Isocarboxazid

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). 

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... 

Clinically important, potentially hazardous interactions with cyclosporine, erythromycin, escitalopram, isocarboxazid, lopinavir, methylphenidate, phenelzine, ritonavir, tranylcypromine, trimipramine... 

In contrast, there are a number of other uncontrolled studies and reviews describing the beneficial use of an MAOI with a tricyclic antidepressant. In addition, one study has reported switching 178 patients from tricyclics to MAOIs within 4 days or less. Of these patients, 63 were given the MAOI while still being tapered from the tricyclic, all without any apparent problems. Nevertheless, in a 6-week randomised doubleblind trial, the combinations of phenelzine or isocarboxazid plus trimi-pramine were less effective than trimipramine alone in patients with mild to moderate depression. Similarly, in a smaller randomised open study, the combination of amitriptyline and tranylcypromine was no more effective than either drug alone. ... 

Tranylcypromine, phenelzine, clomipramine and imipramine appear to be high on the list of drugs that have interacted adversely. Combination of clomipramine with tranyleypromine is particularly dangerous. Amitriptyline, trimipramine and isocarboxazid are possibly safer. 

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