Escinal Drug Interactions

As SSRIs have occasionally been associated with bleeding disorders and other effects on the blood, caution is advised when they are given with drugs known to affect platelet function. Sequential prescribing of different types of antidepressant may also produce adverse reaction and an appropriate drug free interval should elapse between stopping one type of antidepressant and starting another.
SSRIs antidepressant should not generally be given to patients receiving MAOIs or for at least 2 weeks after use. No treatment-free period is necessary after stopping a reversible inhibitor of monoamine oxidase type A (RIMA) and starting an SSRI. Adverse effects such as the serotonin syndrome may also consequence of synergistic interaction.
SSRIs may increase anticoagulant activity of some anticoagulants including acenocoumarol and warfarin.
Antidepressants may antagonize the activity of antiepileptics by lowering the convulsive threshold.
Citalopram, fluoxetiene and fluvoxamine may increase plasma concentrations of astemizole or terfenadine by inhibition of their hepatic cytochrome P450 metabolsim and increase the risk of ventricular arrhythmias; together should be avoided.
Rapid development of delirium was reported in patients when Clarithromycin was added to the existing regimen of fluoxetine and nitrazepam, increased plasma-fluoxetine concentrations produced by the inhibition of cytochrome P450 enzymes by Clarithromycin.