venlafaxine and 5-hydroxytryptophan (Major Drug-Drug)
GENERALLY AVOID: Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors and tryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhoea.
MANAGEMENT: The concomitant use of serotonin reuptake inhibitors and tryptophan should be avoided.