Dangerously high blood pressure has resulted from the combination of tricyclic antidepressants, such as amoxap-ine, and members of another class of antidepressants known as monoamine oxidase (MAO) inhibitors. Because of this, amoxapine should never be taken in combination with MAO inhibitors. Patient taking any MAO inhibitors, for example Nardil (phenelzine sulfate) or Parmate (tranylcypromine sulfate), should stop the MAO inhibitor then wait at least 14 days before starting amoxapine or any other tricyclic antidepressant. The same holds true when discontinuing amoxapine and starting an MAO inhibitor.
Amoxapine may decrease the blood pressure-lowering effects of clonidine. Patients who take both drugs should be monitored for loss of blood-pressure control and the dose of clonidine may be increased as needed.
The sedative effects of amoxapine are increased by other central nervous system depressants such as alcohol, sedatives, sleeping medications, or medications used for other mental disorders such as schizophrenia. The anti-cholinergic effects of amoxapine are additive with other anticholinergic drugs such as benztropine, biperiden, trihexyphenidyl, and antihistamines.
See also Neurotransmitters
American Society of Health-System Pharmacists. AHFS Drug Information 2002. Bethesda: American Society of Health-System Pharmacists, 2002. DeVane, C. Lindsay, Pharm.D. "Drug Therapy for Mood
Disorders." In Fundamentals of Monitoring Psychoactive Drug Therapy. Baltimore: Williams and Wilkins, 1990.
Jack Raber, Pharm.D.
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