I hope this information is useful. D.R.Krishna,Ph.D AvH Scientist Dr. A critical review of the evidence. Sproule BA, Naranjo CA, Brenmer KE, Hassan PC Psychopharmacology Research Program, Sunnybrook Health Science Centre, Toronto, Ontario, Canada. The potential for drug-drug interactions in psychiatric patients is very high as combination psychopharmacotherapy used to treat comorbid psychiatric disorders, to treat the adverse effects of a medication, to augment a medication effect or to treat concomitant medical illnesses.
Interactions can be pharmacodynamic or pharmacokinetic in nature.
The evidence for and clinical significance of these interactions are reviewed, with special emphasis on antipsychotics, tricyclic antidepressants and benzodiazepines. SSRIs serve both as substrates and inhibitors of these enzymes. In vitro studies provide a screening method for evaluating drug affinities for substrates, inhibitors or inducers of CYP enzymes. Although in vitro data are important as a starting point for predicting these metabolic kinetic drug interactions, case reports and controlled experimental studies in humans are required to fully evaluate their clinical significance. This paper systematically reviews both the in vitro and in vivo evidence for drug interactions between SSRIs and other CNS drugs.