Is Prozac Safe With These Other Medications?

QUESTION:

Dear Dr. Heller,

I have been on doxipen for 25 years.  (50 mg.  to 300 mg.)  Tegretol (100 mg.  three times a day) was added in 1997 when trigeminal neuralgia was diagnosed.  Now I've been ask to go on Prozac.  Net says Prozac, doxipen and Tegretol should not be taken together.  But I'll try if it may help.  You opinion would ease my concerns.

ANSWER:

Prozac with Tegretol is fine, the only consequence of taking both is increased blood levels of Tegretol. 

The older SSRI antidepressants such as doxipen can be taken with Prozac, but the individual has the risk of developing serotonin syndrome - especially with higher doses of Prozac or doxipen.  The patient needs to be carefully monitored when these medications are prescribed together.  The only time I used Prozac with doxipen was when doxipen was needed for increasing the appetite.  Since Zyprexa is better in this regard, I no longer prescribe doxipen.