Table 2.
Example of Drug Monograph Extraction and Annotation for SSRI/MAOI Interaction
| Source | Annotation |
|---|---|
| Lexicomp (UpToDate, Inc.) | |
| “The washout period should probably be at least 1-2 weeks (2 weeks for vilazodone, 3 weeks for vortioxetine, 5 weeks for fluoxetine), depending on the half-life of the agent being discontinued. In general, furazolidone, linezolid, and procarbazine will pose less risk than isocarboxazid, phenelzine, or tranylcypromine. Caution is still advised. Selegiline administered in high oral dosages (e.g., more than 10 mg/day of tablet/capsule; more than 2.5 mg/day of orally disintegrating tablet) or transdermally will exhibit nonselective MAOI activity. MAOI Exceptions Linezolid; Methylene Blue; Tedizolid” | Timing: The washout period should probably be at least 1-2 weeks Dose: Selegiline administered in high oral dosages Route: Transdermally, will exhibit nonselective MAOI activity Medication: Furazolidone, linezolid, and procarbazine will pose less risk than isocarboxazid, phenelzine, or tranylcypromine and MAOI exceptions (linezolid, methylene blue, and tedizolid) |
| Micromedex (IBM Corporation) | |
| “At least 14 days (preferably 18-20) should elapse after stopping an MAOI before starting a serotonergic drug. At least 5 weeks should after stopping fluoxetine before starting an MAOI. If possible use an alternative to the serotonergic drug in patients on linezolid or MAO-B inhibitors. Tedizolid does not appear to be a MAOI to a clinically important degree, so is unlikely to increase the risk of serotonin syndrome. Also, depending on the antibiogram, one could consider alternative antibiotics such as vancomycin or telavancin for linezolid” | Timing: At least 14 days should elapse after stopping an MAOI Medication: Tedizolid does not appear to be an MAOI to a clinically important degree |
| Hansten and Horn’s The Top 100 Drug Interactions27 | |
| “Wait at least 14 days after discontinuing an MAOI intended to treat psychiatric disorders before initiating fluoxetine. Wait at least 5 weeks after discontinuing fluoxetine before initiating therapy with an MAOI intended to treat psychiatric disorders” | Timing: Wait at least 14 days after discontinuing an MAOI |