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Abstract ▼ AI-Helper

Since the 1990s, selective serotonin reuptake inhibitors(SSRIs) have been used increasingly to treat depression because of their relatively fewer adverse effects and lower toxicity than older compounds such as tricyclic antidepressants(TCAs) and monoamine oxidase inhibitors(MAOIs). Polypharmacy, by ...

Since the 1990s, selective serotonin reuptake inhibitors(SSRIs) have been used increasingly to treat depression because of their relatively fewer adverse effects and lower toxicity than older compounds such as tricyclic antidepressants(TCAs) and monoamine oxidase inhibitors(MAOIs). Polypharmacy, by several factors such as diseases, genetic constitution, diet, and age-related physiological changes may induce drug interactions predisposed to adverse effects. SSRIs have a low potential for pharmacodynamic drug interactions because they have more selective mechanism of action than older antidepressants. However, a serious pharmacodynamic drug interaction with SSRls, serotonin syndrome should be considered carefully when SSRls are given in combination with agents that affect serotonin levels. SSRls can have potential pharmacokinetic interactions due to their selective inhibitory action on cytochrome P450(CYP) isoenzymes, especially fluoxetine, paroxetine, and fluvoxamine. Therefore, these agents should be closely monitored or avoided in patients treated with substrates of the same isoenzyme. However, citalopram and sertraline have less inhibitory effects on different CYP drug metabolizing enzymes and offer more favorable drug interaction profile. This review provides evidence of potential drug interactions of individual SSRIs. This study may help to guide safe and efficacious care to patients.

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