Interaction between fluvoxamine and imipramine/desipramine in four patients.
We describe four patients in whom the addition of fluvoxamine (100 mg/day) to the treatment with imipramine or desipramine (100-150 mg/day) resulted in a dramatic increase in the plasma concentrations of the tricyclic antidepressants associated with adverse effects. These observations indicate that fluvoxamine inhibits both the demethylation of imipramine and, possibly to a lesser extent, the hydroxylation of desipramine. The combination of fluvoxamine with tricyclic antidepressants should be avoided whenever possible.
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Institute of Pharmacology, University of Messina, Italy.
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D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy; D003891:Desipramine / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D004347:Drug Interactions; D005260:Female; D016666:Fluvoxamine / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007099:Imipramine / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged
D016666:Fluvoxamine; D007099:Imipramine; D003891:Desipramine