Types of drugs that interact with risperidone risperdal include antidepressants, such as paroxetine paxil and fluoxetine sarafem, prozac heartburn medications, such as ranitidine zantac and cimetidine tagamet certain drugs used to treat parkinson s disease, including the dopamine agonists bromocriptine parlodel , cabergoline dostinex , and levodopa dopar, larodopa some drugs used to treat high blood pressure anti-seizure drugs, such as carbamazepine tegretol , phenobarbital luminal, solfoton , and phenytoin dilantin other medications for mental illness, including clozapine clozaril certain antibiotics, such as rifampin rifadin, rimactane sedatives, sleeping pills, and tranquilizers.

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Before using this medicationtell your doctor or pharmacist your medical historyespecially ofpersonal or family history of bipolar/manic-depressive disorderpersonal or family history of suicide attemptsliver problemsdiabeteslow sodium in the bloodsuch as may occur while takingwater pillsdiureticssevere loss of body waterdehydrationseizuresstomach/intestinal ulcerspersonal or family history of glaucomaangle-closure type

There have been reports of both increased and decreased lithium levels when lithium was used concomitantly with fluoxetineCases of lithium toxicity and increased serotonergic effects have been reportedLithium levels should be monitored when these drugs are administered concomitantly.

Patients should be advised that hyponatremia has been reported as a result of treatment with SNRIs and SSRIsincluding SARAFEMSigns and symptoms of hyponatremia include headachedifficulty concentratingmemory impairmentconfusionweaknessand unsteadinesswhich may lead to fallsMore severe and/or acute cases have been associated with hallucinationsyncopeseizurecomarespiratory arrestand deathsee WARNINGS AND PRECAUTIONS

Report any new or worsening symptoms to your doctorsuch asmood or behavior changesanxietypanic attackstrouble sleepingor if you feel impulsiveirritableagitatedhostileaggressiverestlesshyperactivementally or physicallymore depressedor have thoughts about suicide or hurting yourself.

Because of the long elimination half-lives of the parent drug and its major active metabolitechanges in dose will not be fully reflected in plasma for several weeksaffecting both strategies for titration to final dose and withdrawal from treatmentThis is of potential consequence when drug discontinuation is required or when drugs are prescribed that might interact with fluoxetine and norfluoxetine following the discontinuation of fluoxetinesee CLINICAL PHARMACOLOGY and DRUG INTERACTIONS

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