Since the 1990s, selective serotonlri 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 agerelated 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 antideprE~ssants. However, a serious pharmacodynamic drug interaction with SSRIs, serotonin syndrome should be considered carefully when SSRIs are given in combination with agents that affect serotonin levels. SSRIs 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, citaloprarn and sertraline have less inhibitory effects on different CYP drug metabolizincl 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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