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Selective Serotonin Reuptake Inhibitors and Tricyclic Antidepressants in Combination

Interactions and Therapeutic Uses

Published online by Cambridge University Press:  02 January 2018

David Taylor
David Taylor*
Affiliation:
Principal Clinical Pharmacist, Maudsley Hospital, London SE5 8AZ
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Abstract

Background

The selective serotonin reuptake inhibitors (SSRIs) are now widely used in the treatment of depressive illness. Interest has grown in the use of SSRIs as alternatives to tricyclic antidepressants (TCAs) and in the therapeutic use of combinations of SSRIs and TCAs in refractory depression.

Method

MEDLINE and PSYCLit literature searches were conducted. Reference sections from papers retrieved were scrutinised for other relevant reports.

Results

Of 41 relevant articles identified, 35 were selected for review.

Conclusions

Fluoxetine, fluvoxamine, paroxetine and sertraline may substantially increase TCA plasma levels when given concurrently. Such interactions may give rise to adverse effects. The effect of sertraline may be less profound than that of fluoxetine, fluvoxamine and paroxetine. Limited data suggest that citalopram may not affect TCA serum levels. There is scant literature evidence to support the use of SSRIs in combination with TCAs as a treatment for refractory depression.

Type
Review Articles
Information
The British Journal of Psychiatry , Volume 167 , Issue 5 , November 1995 , pp. 575 - 580
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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