Posted by SalArmy4me on August 29, 2001, at 18:46:35
In reply to Taking combination of drugs ok?, posted by Storm on August 29, 2001, at 18:35:28
There are 4 interactions for Prozac , Remeron and lithium :
1 severe, 1 medium, and 2 mild (3 are drug/drug interactions , 1 is a food/drug interaction).
1. Severe Interaction between lithium (generic: lithium) and Prozac (generic: fluoxetine)Several case reports suggest that fluoxetine may elevate serum lithium levels through an unknown mechanism. Patients who must take both drugs should be monitored for evidence of lithium toxicity. One case report has also suggested that the combination of fluoxetine and lithium may produce the "serotonin syndrome," which manifests akathisia, myoclonus, increased reflexes, shivering, tremor, diarrhea, and ataxia.
References:
1. Hadley A, Cason MP. Mania resulting from lithium-fluoxetine combination. Am J Psychiatry. 1989;146:1637-8. more info
2. Muly EC, McDonald W, Steffens D, Book S. Serotonin syndrome produced by a combination of fluoxetine and lithium. Am J Psychiatry. 1993;150:1565. more info
3. Noveske FG, Hahn KR, Flynn RJ. Possible toxicity of combined fluoxetine and lithium. Am J Psychiatry. 1989;146:1515. more info
4. Salama AA, Shafey M. A case of severe lithium toxicity induced by combined fluoxetine and lithium carbonate. Am J Psychiatry. 1989;146:278. more info
2. Medium Food Interaction for Remeron (generic: mirtazapine)
Grapefruit juice, by inhibiting cytochrome P-450 3A4 enzymes could theoretically reduce mirtazapine clearance. The clinical significance, if any, of this potential interaction is unknown. It is recommended that the clinician be aware of a potential increased response to mirtazapine in patients regularly consuming grapefruit juice.
References:
1. Anonymous. Product Information. Remeron (mirtazapine). Organon, West Orange, NJ. PROD; : .3. Mild Interaction between lithium (generic: lithium) and Remeron (generic: mirtazapine)
CNS-depressant and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects.
poster:SalArmy4me
thread:76866
URL: http://www.dr-bob.org/babble/20010828/msgs/76869.html