Table 3.

Pharmacokinetic interactions between antidepressants and antipsychotics, and the CYP-450 isozymes involved

	Haloperidol	Pimozide	Clozapine	Risperidone	Olanzapine
TCAs	TCAs↑	TCAs↑	na	na	na
	CYP2D6	CYP2D6, CYP3A4
Fluoxetine	AP↑		AP↑ 40%–70%	Active AP↑ 75%	na
	CYP2D6		CYP1A2, CYP2D6, CYP2C19, CYP3A4	CYP2D6, CYP3A4	CYP2D6
Paroxetine	na	na	AP↑ 20%–40%	Active AP↑↑ 45%	na
			CYP2D6	CYP2D6
Fluvoxamine	↑ 1.8–4.2-fold	na	AP↑ 5–10-fold	AP↑ 10%–20%	AP↑ 2-fold
	CYP1A2, CYP3A4		CYP1A2, CYP2C19, CYP3A4	CYP2D6, CYP3A4	CYP1A2
Sertraline	AP↑	AP↑	na	AP↑	na
	CYP2D6	CYP3A4, CYP1A2		CYP2D6
Citalopram/escitalopram	na	AP↑	na	na	na
Nefazodone		CYP3A4

Note:↑, increase.

Abbreviations: TCA, tricyclic antidepressant; CYP, cytochrome P; AP, antipsychotics; na, not applicable.