Studies in patients and
in vitro investigations have shown that fluoxetine and its
metabolite, norfluoxetine, inhibits CYP2D6, the
enzyme that metabolises
flecainide. Paroxetine is expected to have similar effects and the manufacturers of escitalopram predict that it may also interact in this way.
There appear to be no reported interactions, but, given that fluoxetine interacts this way with other CYP2D6 substrates, it would seem prudent to be alert for increased and prolonged effects if any of these
SSRIs is given with
flecainide.