Selective serotonin reuptake inhibitors and isoniazid: evidence of a potential adverse interaction.
BACKGROUND
Recognizing a potential interaction between isoniazid (INH), a weak monoamine oxidase inhibitor, and serotonin reuptake inhibitors (SSRIs), we assessed medication discontinuation rates in human immunodeficiency virus-infected individuals taking an SSRI, INH, or both.


METHODS
We retrospectively reviewed treatment records to determine if patients on an SSRI, INH, or both completed drug therapy in accordance with a treatment plan (e.g., 12 months of INH therapy). Patients on both medications constituted the study group; patients taking either an SSRI or INH alone constituted comparison groups.


RESULTS
There were no significant differences between the groups based on age, gender, CD4%, or CD4 count. Seven of the 10 patients (70%) in the study group discontinued therapy, which was significantly greater than the 2 of 14 (14%) in the SSRI group (P = 0.01) and the 4 of 18 (22%) in the INH group (p = 0.02) who discontinued therapy.


CONCLUSIONS
Medication discontinuation rates for patients prescribed an SSRI coincident with INH were significantly higher than for individuals prescribed these medications separately. These differences cannot be accounted for on the basis of age, gender, or CD4%, but they may be attributable to increased side effects caused by interactions between these medications.
Doyle
M E
ME
Department of Psychiatry, Walter Reed Army Medical Center, Washington, DC 20005, USA.
Hicks
D
D
Aronson
N E
NE
D000328:Adult; D000704:Analysis of Variance; D000995:Antitubercular Agents / Q000009:adverse effects*; D016009:Chi-Square Distribution; D004347:Drug Interactions; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000009:adverse effects*; D008297:Male; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D016312:Treatment Refusal
D000995:Antitubercular Agents; D007538:Isoniazid; D017367:Selective Serotonin Reuptake Inhibitors