Selective Serotonin Reuptake Inhibitors and CNS Drug Interactions

  title={Selective Serotonin Reuptake Inhibitors and CNS Drug Interactions},
  author={Beth A. Sproule and Claudio A. Naranjo and Karen E. Bremner and Paul C. Hassan},
  journal={Clinical Pharmacokinetics},
SummaryThe potential for drug-drug interactions in psychiatric patients is very high as combination psychopharmacotherapy is used to treat comorbid psychiatric disorders, to treat the adverse effects of a medication, to augment a medication effect or to treat concomitant medical illnesses. Interactions can be pharmacodynamic or pharmacokinetic in nature. This paper focuses on the metabolic kinetic interactions between selective serotonin reuptake inhibitors (SSRIs) and other central nervous… 

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The potential for metabolically based drug interactions of any new psychotropic agent may be anticipated on the basis of knowledge about the CYP enzymes responsible for its metabolism and about its effect on the activity of these enzymes.

Clinically Significant Drug Interactions with Antidepressants in the Elderly

Among other newer antidepressants, nefazodone is a potent inhibitor of CYP3A4 and its combination with substrates of this isoform should be avoided, and citalopram and sertraline have a low inhibitory activity on different drug metabolising enzymes and appear particularly suitable in an elderly population.

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