Risk of serotonin syndrome w/ MAOIs. Increased AUC & C
max of ramelteon. Increased plasma levels of TCAs (eg, clomipramine, imipramine, amitriptyline), neuroleptics (eg, clozapine, olanzapine, quetiapine), benzodiazepines (eg, triazolam, midazolam, alprazolam, diazepam), caffeine, ropinirol, propranolol. Increased plasma conc & prolonged prothrombin time of warfarin. Cardiac toxicity w/ thioridazine. Enhanced serotonergic effects w/ other serotonergic agents eg, triptans, tramadol, SSRIs, St. John's wort prep; lithium. Increased risk of haemorrhage w/ oral anticoagulants. Avoid use w/ alcohol. Drugs w/ narrow therapeutic index; terfenadine, astemizole, cisapride, sildenafil.