Slt SSRIs and SNRIs/Tricyclic Compounds; Trazodone Interactions
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
When these two medicines are taken together, your body may not process your tricyclic antidepressant or trazodone properly.
What might happen:
The blood levels of your tricyclic antidepressant or trazodone may increase and cause toxic effects.
What you should do about this interaction:
If you experience blurred vision, dry mouth, urinary retention, mental or mood changes, increase drowsiness, confusion, or seizures, contact your healthcare professionals (e.g. doctor or pharmacist). Your doctor may want to adjust the dose of your medicine.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
- 1.Preskorn SH, Beber JH, Faul JC, Hirschfeld RM. Serious adverse effects of combining fluoxetine and tricyclic antidepressants. Am J Psychiatry 1990 Apr;147(4):532.
- 2.Bergstrom RF, Peyton AL, Lemberger L. Quantification and mechanism of the fluoxetine and tricyclic antidepressant interaction. Clin Pharmacol Ther 1992 Mar;51(3):239-48.
- 3.Maskall DD, Lam RW. Increased plasma concentration of imipramine following augmentation with fluvoxamine. Am J Psychiatry 1993 Oct;150(10):1566.
- 4.Spino E, Campo GM, Avenoso A, Pollicino MA, Caputi AP. Interaction between fluvoxamine and imipramine/desipramine in four patients. Ther Drug Monit 1992 Jun;14(3):194-6.
- 5.Bertschy G, Vandel S, Vandel B, Allers G, Volmat R. Fluvoxamine-tricyclic antidepressant interaction. An accidental finding. Eur J Clin Pharmacol 1991;40(1):119-20.
- 6.Cymbalta (duloxetine hydrochloride) US prescribing information. Eli Lilly and Company January, 2017.
- 7.Seifritz E, Holsboer-Trachsler E, Hemmeter U, Eap CB, Baumann P. Increased trimipramine plasma levels during fluvoxamine comedication. Eur Neuropsychopharmacol 1994 Mar;4(1):15-20.
- 8.Skjelbo E, Brosen K. Inhibitors of imipramine metabolism by human liver microsomes. Br J Clin Pharmacol 1992 Sep;34(3):256-61.
- 9.Preskorn SH, Alderman J, Chung M, Harrison W, Messig M, Harris S. Pharmacokinetics of desipramine coadministered with sertraline or fluoxetine. J Clin Psychopharmacol 1994 Apr;14(2):90-8.
- 10.Van Hoey NM. Effect of cyclobenzaprine on tricyclic antidepressant assays. Ann Pharmacother 2005 Jul-Aug;39(7-8):1314-7.
- 11.Flexeril (cyclobenzaprine) US prescribing information. McNeil Consumer and Speciality Pharmaceuticals April, 2013.
- 12.Nisijima K, Shimizu M, Abe T, Ishiguro T. A case of serotonin syndrome induced by concomitant treatment with low-dose trazodone and amitriptyline and lithium. Int Clin Psychopharmacol 1996 Dec; 11(4):289-90.
- 13.Keegan MT, Brown DR, Rabinstein AA. Serotonin syndrome from the interaction of cyclobenzaprine with other serotoninergic drugs. Anesth Analg 2006 Dec;103(6):1466-8.
- 14.Michalets EL, Smith LK, Van Tassel ED. Torsade de pointes resulting from the addition of droperidol to an existing cytochrome P450 drug interaction. Ann Pharmacother 1998 Jul-Aug;32(7-8):761-5.
- 15.Drew BJ, Ackerman MJ, Funk M, Gibler WB, Kligfield P, Menon V, Philippides GJ, Roden DM, Zareba W. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. J Am Coll Cardiol 2010 Mar 2;55(9):934-47.
- 16.Amrix (cyclobenzaprine extended release) US prescribing information. Teva Pharmaceuticals Ltd. May, 2016.
- 17.Pristiq (desvenlafaxine succinate) US prescribing information. Wyeth Pharmaceuticals, Inc. February 8, 2018.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.