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Selective Serotonin Reuptake Inhibitors (Clomipramine, Fluoxetine) (view source)

Revision as of 13:12, 12 September 2014

539 bytes removed ,  13:12, 12 September 2014
→‎Interactions
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'''Care should be taken if used in conjunction with any of the following drugs, which may interact and cause adverse effects:'''
 
'''Care should be taken if used in conjunction with any of the following drugs, which may interact and cause adverse effects:'''
 
*Opioids (e.g. morphine): enhanced analgesia and respiratory depression.
 
*Opioids (e.g. morphine): enhanced analgesia and respiratory depression.
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*MAOIs: risk of serotonin syndrome, advise washout period of 2-3 weeks between treatment with these drugs.
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*MAOIs: risk of serotonin syndrome, advise washout period of 2-3 weeks between treatment with these drugs<ref>Brown, T.M., Skop, B.P., Mareth, T.R., 1996. Pathophysiology and management of the serotonin syndrome. The Annals of Pharmacotherapy 30, 527–533.</ref>.
 
*Phenothiazines: increased shared adverse effects (CVS, etc), mutual increase in serum levels due to competition for cytochrome p450. Definite risk of severe adverse affects and toxicity.
 
*Phenothiazines: increased shared adverse effects (CVS, etc), mutual increase in serum levels due to competition for cytochrome p450. Definite risk of severe adverse affects and toxicity.
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*SSRIs: Fluoxetine inhibits Cytochrome p450, leading to toxic levels of TCA. Cimetidine also has this effect.
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*Thyroid medications: if used simultaneously patients must be carefully monitored <ref>Gullikers, K.P., Panciera, D.L., 2002. Influence of various medications on canine thyroid function. Compendium of Continuing Education for the Practicing Veterinarian 24, 511-521</ref>
 +
*Inhibitors of cytochrome p450, including other SSRI drugs, ketoconazole and cimetidine.
 +
*Drugs which lower seizure threshold (eg. phenothiazines such as acepromazine or chlorpromazine).
 
*Fibre rich diets reduce availability of TCAs.
 
*Fibre rich diets reduce availability of TCAs.
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*Thyroid medications: can interfere, therefore if simultaneously used must be carefully monitored <ref>Gullikers, K.P., Panciera, D.L., 2002. Influence of various medications on canine thyroid function. Compendium of Continuing Education for the Practicing Veterinarian 24, 511-521</ref>
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*Amitraz
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  −
'''Care should be taken if used in conjunction with any of the following drugs, which may interact and cause adverse effects:'''
  −
*Fluoxetine should not be given at the same time as drugs which lower seizure threshold eg. phenothiazines such as acepromazine or chlorpromazine.
  −
*Monoamine oxidase inhibitors (MAOI), or within a period of 2 weeks after discontinuation of treatment with a MAOI due to the risk of serotonin syndrome<ref>Brown, T.M., Skop, B.P., Mareth, T.R., 1996. Pathophysiology and management of the serotonin syndrome. The Annals of Pharmacotherapy 30, 527–533.</ref>
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*Fluoxetine has not been evaluated with drugs that affect the cytochrome P450 enzyme, care should therefore be taken with any drug that affects the enzyme system eg. ketoconazole.
      
===Serotonin syndrome===
 
===Serotonin syndrome===
Jon Bowen
694

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