Drug Interactions

Stress Reduction. Making changes in your life to help control and reduce stress. Too much stress exacerbates depression and puts you at risk for depression in the future.
Medication. Antidepressant medications can make psychotherapy more effective, for some people. Someone who is too depressed to talk, for instance, can’t get much benefit from psychotherapy or counseling; but often, the right medication will improve symptoms so that the person can respond better. Prozac is an agent in a newer class of antidepressant medication known as selective serotonin reuptake inhibitors (SSRIs). Depression and anxiety disorders might be caused by a chemical imbalance in the brain. One of these chemicals is serotonin, which helps send electrical signals from one nerve cell to another. In the process, serotonin is released from one nerve cell (the sender) and travels to the next (the receiver), where it is either absorbed or returns back to the original sender cell.

Drug Interactions

The interaction between monoamine oxidase inhibitors (MAOIs) and SSRIs is the most important drug interaction limiting SSRI use. This combination may lead to the development of a hyperserotonergic syndrome consisting of excitement, diaphoresis, rigidity, hyperthermia, tachycardia, hypertension, and possibly death. The severity of this interaction necessitates at least 5 week washout when switching a patient from fluoxetine to an MAOI to allow complete elimination of the fluoxetine. At least 14 days should be allowed after stopping citalopram, escitalopram, paroxetine or sertraline before starting an MAOI. This difference in washout time between fluoxetine and citalopram, escitalopram, paroxetine and sertraline when switching from an SSRI to an MAOI is one of the key differences between SSRIs.

Citalopram, escitalopram and sertraline have the lowest potential for drug interactions among the SSRIs. Citalopram should be avoided in patients likely to take overdoses. Sertraline would be preferable for cardiac patients taking beta blockers or type IC antiarrhythmic agents.

Taking thioridazine with paroxetine or fluoxetine may cause serious heart problems.

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