● with pimozide • ● ● Action● ● ● Contraindications and PrecautionsContraindicated in:● tant use with, or within 14 days’ use of, MAOIs • ● Adverse Reactions and Side Effectsconcomitant use with thioridazine (or within 5 weeks after dis-continuation of fl• Pregnancy and lactationinsuffiderweight or anorexic patients • Patients with hepatic or renal with cisapride, thioridazine, or pimozide • Use Cautiously in:trate with disulficomitant use with thioridazine • ●^424 Headache Selectively inhibit the central nervous system neuronal uptake Sexual dysfunction Nausea Diarrheaof serotonin (5-HT) AnorexiaInsomnia Constipation^ ● ciency • Elderly or debilitated patients • Suicidal patients^ PSYCHOTROPIC MEDICATIONS ramSertraline: uoxetine) • • Patients with history of seizures • Un- • Hypersensitivity to SSRIs • Concomi-coadministration of oral concen-Fluvoxamine: Sertraline: concomitant use Paroxetine:concomitant use Fluoxetine: con-^
2 2506_Ch26_417-446.indd 1424 506 Ch 26 417 - 446 .ind● ● Interactions● ● ● ● d tonin syndrome include diarrhea, cramping, tachycardia, labile blood pressure, diaphoresis, fever, tremor, shivering, Serotonin syndrome may occur with concomitant use of SSRIs and restlessness, confusion, disorientation, mania, myoclonus, hy-perreflIncreased risk of suicidality in children and adolescents (black box warning)Dry mouthToxic, sometimes fatal, reactions have occurred with concom-itant use of Serotonin syndrome. Can occur if taken concurrently with other medications that increase levels of serotonin (e.g., MAOIs, tryptophan, amphetamines, other antidepressants, Increased effects of SSRIs with buspirone, lithium, dopamine agonists, or serotonin 5-HTSomnolence lithium, linezolidreceptor agonists [agents for migraine]). Symptoms of sero- 1424 metoclopramide exia, ataxia, seizures, cardiovascular shock, and death. MAOIs, and. , St. John’s wort.sibutraminecimetidine, , tramadol, serotonin L-tryptophan,^1 1 10/1/10 9:39:20 AM 0 / 1 / 10 9 : 39 : 20 AM
