Drug General Information (ID: DDITPA4HLG)
Drug Name			Protriptyline		Drug Info		Flumazenil		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antidepressants				Antidotes
Structure

Mechanism of Protriptyline-Flumazenil Interaction (Severity Level: Major)
Increased risk of lowers seizure threshold Click to Show/Hide Mechanism Graph
Drug Name		Protriptyline				Flumazenil
Mechanism		Lower seizure threshold				Lower seizure threshold
Key Mechanism Factor 1
		Factor Name		Lowers seizure threshold
		Factor Description		The combination of medications that lower the seizure threshold is a factor that makes people with epilepsy more likely to have seizures. A seizure is a sudden, uncontrolled electrical disturbance in the brain that can cause changes in your behavior, movements or sensations, and level of consciousness.
Mechanism Description		Increased risk of lowers seizure threshold by the combination of Protriptyline and Flumazenil

Recommended Action
Management		Administration of flumazenil should be avoided in patients who are known or suspected to have received overdoses of tricyclic antidepressants.

References
1	Bodenham AR "Death after flumazenil." BMJ 299 (1989): 457.[PMID: 2507014]
2	Marchant B, Wray R, Leach A, Nama M "Flumazenil causing convulsions and ventricular tachycardia." BMJ 299 (1989): 860.[PMID: 2510872]
3	Mordel A, Winkler E, Almog S, Tirosh M, Ezra D "Seizures after flumazenil administration in a case of combined benzodiazepine and tricyclic antidepressant overdose." Crit Care Med 20 (1992): 1733-4.[PMID: 1458953]