Posted by Mr. Scott on February 11, 2002, at 19:10:43
In reply to help needed with son!, posted by e503 on February 9, 2002, at 22:08:07
I've watching this thread and contributing when I can. It is also noteworthy that Zoloft dramatically increases Risperidone, perhaps increasing akathesia through further dopamine inhibition.
A change to Paxil would worsen this increase in Risperadone further. A change to Celexa would leave the Risperdal level only mildly above what it should be. Attached is a cut and paste from the P450 liver enzyme/medication tool from Harvard.
Scott
Risperidone and Paroxetine/Fluoxetine
Levels of risperidone are increased with the addition of paroxetine or fluoxetine.A case has been reported of serotonin syndrome on the risperidone and paroxetine combination.I
n addition, cases of EPS has been reported with these combinations that may be related to both increased concentration of RSP and a pharmacodynamic effect of serotonin on dopamine receptors.
ReferencesEreshefsky L, et al. Antidepressant drug interactions and the cytochrome P450 system. The role of cytochrome P450 2D6.Clin Pharmacokinet. 1995;29 Suppl 1:10-8; discussion 18-9
Sproule BA, et al. Selective serotonin reuptake inhibitors and CNS drug interactions. A critical review of the evidence. Clin Pharmacokinet. 1997 Dec;33(6):454-71. Review
Hamilton S and Malone K: Serotonin syndrome during treatment with paroxetine and risperidone. J Clin Psychopharmacol 20: 103-104, 2000
Abstract
There is inhibition on all CYP pathways. (Minor pathways are disregarded.) This may heighten the impact of this interaction.
poster:Mr. Scott
thread:93523
URL: http://www.dr-bob.org/babble/20020208/msgs/93798.html