Why are MAOIs contraindicated with SSRIs?
It is generally considered dangerous to combine monoamine oxidase inhibitors and SSRIs because MAOIs inhibit serotonin metabolism and can result in circulating serotonin levels that are high enough to produce cardiotoxic and neurotoxic serotonin syndrome.
Which drugs cause serotonin syndrome?
The drugs and supplements that could potentially cause serotonin syndrome include: Selective serotonin reuptake inhibitors (SSRIs), antidepressants such as citalopram (Celexa), fluoxetine (Prozac), fluvoxamine (Luvox), escitalopram (Lexapro), paroxetine (Paxil, Pexeva, Brisdelle) and sertraline (Zoloft)
Can you take MAOI with SSRI?
The use of SSRIs and SNRIs should be avoided with an MAOI because of the risk of serious adverse effects and even death. The combination has a high risk of serotonin syndrome, and deaths have been reported when taken at therapeutic doses.
How do MAOIs increase serotonin?
MAOIs elevate levels of the neurotransmitters norepinephrine, serotonin, and dopamine in the brain by inhibiting an enzyme called monoamine oxidase. Monoamine oxidase breaks down norepinephrine, serotonin, and dopamine.
What drugs Cannot be taken with MAOIs?
What drugs interact with MAOIs? MAO inhibitors should be avoided with other antidepressants such as paroxetine fluoxetine, amitriptyline, nortriptyline, bupropion; pain medications like methadone, tramadol, and meperidine; dextromethorphan, St. Johns Wort, cyclobenzaprine, and mirtazapine.
How much time should elapse between giving MAOIs and SSRIs?
When clinicians feel the need to switch from one class of agent to the other, it is suggested that at least five half-lives elapse between the time the SSRI is stopped and the MAOI is started.
What are the signs of serotonin syndrome?
Gastrointestinal symptoms include diarrhea and vomiting. Nervous system symptoms include overactive reflexes and muscle spasms, said Su. Other serotonin syndrome symptoms include high body temperature, sweating, shivering, clumsiness, tremors, and confusion and other mental changes.
How do you treat serotonin syndrome?
Depending on your symptoms, you may receive the following treatments:
- Muscle relaxants.
- Serotonin-production blocking agents.
- Oxygen and intravenous (IV) fluids.
- Drugs that control heart rate and blood pressure.
- A breathing tube and machine and medication to paralyze your muscles.
Do MAOIs have more side effects than SSRIs?
MAOIs cause more side effects than SSRIs. Side effects include: Nausea, diarrhea, or constipation. Dry mouth.
What are common side effects of MAOIs that it’s should be aware of?
Common side effects of MAOIs may include:
- Sleepiness, or trouble getting to sleep.
- Dizziness, lightheadedness, and fainting.
- Dry mouth, blurred vision, and appetite changes.
- High or low blood pressure.
- Changes in heart rate and rhythm.
Why are MAOIs considered a last resort antidepressant?
Tricyclics and other mixed or dual action inhibitors are third line, and MAOI’s (monoamine oxidase inhibitors) are usually medications of last resort for patients who have not responded to other medications, due to their low tolerability, dietary restrictions, and drug-drug interactions.
What is the washout period for MAOI and SSRI?
From SSRIs to TCAs and from TCAs to SSRIs because certain SSRIs (mostly fluvoxamine, fluoxetine and paroxetine) will inhibit the metabolism of TCAs. To a new serotonergic antidepressant or MAOI, because of the risk of serotonin syndrome. From a non-selective irreversible MAOI: a 2-week washout period is required.
How do you get rid of serotonin syndrome?
How do I get rid of serotonin toxicity?
Is Prozac an MAO inhibitor?
Prozac is the brand name of the drug fluoxetine, a selective serotonin reuptake inhibitor (SSRI). SSRIs are second-generation antidepressants, which means they are newer than first-generation medications such as monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants (TCAs).
What is the difference between MAO inhibitors and SSRIs?
Although SSRIs are the current frontline treatment for depression, MAOIs (monoamine oxidase inhibitors) were the first antidepressants developed. They are typically more potent than SSRIs because they affect more neurotransmitters, and they can cause more side effects.