Final answer:
Tricyclic antidepressants, such as amitriptyline, doxepin, nortriptyline, and amoxapine, should not be combined with monoamine oxidase inhibitors due to the risk of severe interactions. Healthcare providers must carefully consider existing medications and contraindications before prescribing these drugs.
Step-by-step explanation:
Amitriptyline, doxepin, nortriptyline, and amoxapine are all classified as tricyclic antidepressants. These medications are primarily used to treat major depression and are known for their three-ring chemical structure. A crucial aspect to consider is that these medications should not be used in conjunction with monoamine oxidase inhibitors (MAOIs), such as phenelzine (Nardil), isocarboxazid (Marplan), and tranylcypromine (Parnate). The combination of tricyclic antidepressants with MAOIs can lead to serious, sometimes fatal, interactions including severe high blood pressure crises due to excessive accumulation of neurotransmitters.
Aside from MAOIs, tricyclic antidepressants like amitriptyline are contraindicated with a range of substances and conditions due to their side effects profile and potential for fatal overdose. It is important for healthcare providers to thoroughly review a patient's medication history and assess for potential contraindications and interactions before prescribing these antidepressants.