[Drug interactions and new antidepressive agents]

The mechanism of action of new antidepressants is characterized by a specific inhibition of the serotonin reuptake at synaptic level. In France, fluoxetine, fluvoxamine, and more recently paroxetine are extensively used. Based on a review of the literature, the authors report the interactions of these new antidepressants with psychotropic and other drugs, that are frequently associated with them. All studies report the frequent occurrence of interaction when the new serotonergic antidepressants are associated with tricyclic ones. The increase of tricyclic drug plasma levels is often high with side effects as a consequence. If the pharmacodynamic aspects of these interactions are not well known, the pharmacokinetics are easier to understand, due to the power of these new antidepressants to inhibit cytochrome P450.