Watch out for drug–drug interactions, too!
CMAJ 1999;160:479
Evelinda Trindade and colleagues report on the important issue of adverse effects related to the use of antidepressant medications1 [full text]. Although their meta-analysis yielded helpful information that might be used by the clinician in making choices about antidepressant medications, it did not address the important issue of drug–drug interactions.
In choosing the "right" antidepressant for an individual it is imperative to consider carefully any concurrently prescribed medications. The selective serotonin reuptake inhibitors (SSRIs) are known to interact with many medications, including benzodiazepines, some antipsychotics, tricyclic antidepressants and antihistamines.
When the potential for drug–drug interactions exists, the decision as to which antidepressant will be most appropriate acquires another level of complexity. Physicians who prescribe SSRIs must be well acquainted not only with the adverse effects commonly experienced when the drugs are given in isolation, but also with their particular drug–drug interaction profiles.
George Dresser, MD
Fellow
Clinical Pharmacology and Therapeutics
University of Western Ontario
London, Ont.
gdresser@julian.uwo.ca
Competing interests: None declared.
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Reference
- Trindade E, Menon D, Topfer LA, Coloma C. Adverse effects associated with selective serotonin reuptake inhibitors and tricyclic antidepressants: a meta-analysis. CMAJ 1998;159(10):1245-52.
