Antidepressants' Interactions and Side Effects

In the treatment of depression, antidepressants should take into account the peculiarities of their interaction with other drugs. In the case of a combination of antidepressants with lithium preparations (lithium carbonate) or thyroid hormones (triiodothyronine), the antidepressant effect may increase.


When the TCA is combined with alcohol, the sedative effect is markedly increased and psychomotor disorders can occur. Against the background of alcohol detoxification requires treatment with several large doses of antidepressant than in normal cases.

When fluoxetine or venlafaxine is combined with conventional antipsychotics, extrapyramidal symptoms may occur, since the metabolism of these drugs occurs with the help of a single enzyme (CYP2D6).

Fluoxetine, paroxetine and fluvoxamine can enhance the severity of psychomotor disorders if they are used in conjunction with alprazolam or tranquilizers of the benzodiazepine series.

Fluoxetine and Citalopram are dangerous to combine together with lithium preparations, since in this case the risk of serotonin syndrome appears to increase significantly and the effect of neurotoxicity increases. Most other SSRIs increase the toxicity of lithium.

Some antibiotics (erythromycin) can increase the concentration in the blood of sertraline and citalopram and even cause psychosis in the case of a combination with fluroxetine (clarithromycin).

When combining depression with delusions and hallucinations, the appointment of atypical neuroleptics (risperidone, olanzapine) with antidepressants (fluoxetine, mirtazapine) is usually combined, the effectiveness of such treatment reaches 60-70%.

Patients with signs of bipolar affective disorder are recommended to use olanzepine, because in addition to the effect of neuroleptic, it also has the effect of a mood stabilizer.

Stabilizers of mood can not only prevent a relapse of depression. In the past, there have been attempts to treat these drugs with depressive disorder disorders, but it turned out that these drugs better manage manic states than depression.

Preparations with antioxidant properties can also be used in the pharmacotherapy of disorders of the depressive spectrum.