Question

Of the following combinations of medications, which one would the knowledgeable psychiatrist most want to avoid?

A. Fluoxetine-lithium
B. Fluoxetine-phenelzine
C. Citalopram-valproic acid
D. Citalopram-aripiprazole
E. Mirtazapine-lamotrigine

Answer 1

A psychiatrist would avoid combination B, Fluoxetine-phenelzine, to prevent serotonin syndrome, a dangerous condition caused by high levels of serotonin due to the concurrent use of SSRIs and MAOIs.

Step-by-step explanation:

Among the given combinations of medications, a knowledgeable psychiatrist would most want to avoid combination B, Fluoxetine-phenelzine. Fluoxetine is a Selective Serotonin Reuptake Inhibitor (SSRI), and phenelzine is a monoamine oxidase inhibitor (MAOI). SSRIs like fluoxetine increase serotonin levels in the central nervous system by preventing their reuptake, while MAOIs, such as phenelzine, inhibit the enzyme monoamine oxidase that breaks down neurotransmitters such as serotonin. When taken together, SSRIs and MAOIs can lead to a dangerous and potentially life-threatening condition known as serotonin syndrome, characterized by high levels of serotonin accumulation in the brain. To prevent this, a psychiatrist would avoid prescribing these two classes of medications together.