CARBAMAZEPINE AND SSRIS

Case reports indicate that carbamazepine levels can be increased by fluoxetine and fluvoxamine. Toxicity may develop. Citalopram, paroxetine and sertraline do not normally affect carbamazepine levels, but carbamazepine may reduce their levels. Isolated cases of a Parkinsonian and serotonin syndrome have occurred when fluoxetine was given with carbamazepine, and an isolated case of pancytopenia has been reported when sertraline was given with carbamazepine. Consideration should be given to the fact that SSRIs have been known to cause seizures.
Reports of an adverse interaction seem rare, but bear these reactions in mind during concurrent use. Carbamazepine toxicity may present as nausea, vomiting, ataxia or drowsiness. Consider monitoring carbamazepine levels if fluoxetine or fluvoxamine is started.