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Drug or food interactions

Tell the doctor what medications are currently being taken because many medicines interact with SSRIs. Do not take any nonprescription or herbal medications without first consulting a doctor or pharmacist. The following are examples of interactions, but they do not represent a complete list.

• When an SSRI is administered with 5-HT1 agonists, such as sumatriptan or zolmitriptan, weakness and incoordination, although rare, have been reported.



• SSRIs may increase the blood levels and risk of toxicity of certain medications, including the following:
  
  
  • Highly protein-bound medicines such as warfarin (Coumadin) and digoxin
  
  
  
  • Antiarrhythmic medicines such as propafenone (Rythmol) or flecainide (Tambocor)
  
  
  
  • Beta-blockers such as propranolol (Inderal) or metoprolol (Lopressor, Toprol XL)
  
  
  
  • Tricyclic antidepressants such as amitriptyline (Elavil) (may increase risk for serotonin syndrome—symptoms include hypertension, fever, muscle tremor, or confusion)
  
  
  
  • Benzodiazepines such as alprazolam (Xanax), diazepam (Valium), midazolam (Versed), or triazolam (Halcion)
  
  
  
  • Carbamazepine (Tegretol)
  
  
  
  • Cisapride (Propulsid)
  
  
  
  • Clozapine (Clozaril)
  
  
  
  • Cyclosporine (Neoral, Sandimmune)
  
  
  
  • Haloperidol (Haldol)
  
  
  
  • Thioridazine (Mellaril)
  
  
  
  • Phenytoin (Dilantin)
  
  
  
  • Pimozide (Orap)
  
  
  
  • Theophylline (TheoDur, TheoBid)
     
• The following substances may increase toxicity of SSRIs:
  
  
  • Alcohol or other drugs that depress the central nervous system
  
  
  
  • Diuretics (water pills)
  
  
  
  • MAOIs (may cause serious, and sometimes fatal, reactions)
  
  
  
  • St. John’s wort 
  
  
  
  • Sympathomimetics such as pseudoephedrine (Sudafed)
  
  
  
  • Lithium
  
  
  
  • Sibutramine (Meridia)
  
  
  
  • Zolpidem (Ambien)