Probable Interaction between Trazodone and Carbamazepine

Abstract

The need to maintain long-term treatment of chronic pathologies makes the appearance of interactions possible when such therapies incorporate other drugs to deal with the aggravation of the same or other intercurrent pathologies. A case is presented in which the addition of trazodone to a chronic treatment with carbamazepine (CBZ) is associated with symptoms typical for intoxication by this antiepileptic, accompanied by a raised serum concentration. When the trazodone was suspended, these symptoms lessened and the concentration of CBZ decreased progressively, suggesting a probable interaction between the 2 drugs.

Pharmacokinetic Interactions Between Antiseizure and Psychiatric Medications

“…A 53-year-old man with a secondarily generalized partial epilepsy treated with CBZ received trazodone (100 mg/day) and a relevant increase of serum C/D ratio of CBZ with no signs of toxicity was found [ 70 ]. In another report of a 77-year-old woman chronically treated with carbamazepine, the addition of trazodone was found to increase CBZ serum concentrations with symptoms of carbamazepine toxicity and to return to baseline with a progressive reduction of toxic symptoms after trazodone discontinuation [ 71 ]. These effects may be attributed to CYP3A4 inhibition.…”

Optimizando farmacoterapia mediante la deprescripción: reporte de caso

“…Trazodona se metaboliza por CYP3A4, por lo cual disminuye su concentración y aumenta niveles de carbamazepina en sangre, lo cual aumenta el riesgo de síndrome serotoninérgico [12].…”