Parkinson's Movement
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Azilect and antidepressants ( used for sleep problems)

I am taking Azilect 1 MG, along with two other meds, (Amantadine & Carbidopa-Levo).

I was experiencing sleep problems and told my PD neurologist, who prescibed Trazodone 50 MG Tablet....Directions instruct: TAKE ONE TABLET BY MOUTH AT BEDTIME INCREASING TO 2 TABLETS IF NEEDED FOR SLEEP.

Earlier this year I shared this information with another person on HealthUnlocked, PD blog.

After doing this another PD person wrote a response saying it was very dangerous.....This "frightened" me, so even though my PD doctor prescribed it, I haven't used it yet.

This morning I found this...(I should have just called my PD doctor)

While taking antidepressants with Azilect is "normally" not recommended because of serious effects.....there was a a study that allowed the type my PD doctor prescribed me. Here is my finding found on the net this morning.

Dr. Sanchez-Ramos said...

Thursday, February 23, 2012

I looked into the warning on the use of AZILECT with anti-depressants. After reading this material, speak to your neurologist about the anti-depressant to use. Also you can show this to your Pharmacist. You should know that certain antidepressants were allowed in all AZILECT Phase III clinical trials without adverse effects.

TEVA the producer of AZILECT provided the following information:

• The following antidepressants and doses were allowed in AZILECT Phase III clinical trials:

Generic name, Brand name, Class, Dose allowed

Amitriptyline, Elavil®, Endep®, Vanatrip® tricyclic =50 mg/day

Paroxetine, Paxil®, Paxil CR®, Pexeva® SSRI =30 mg/day

Sertraline, Zoloft® SSRI =100 mg/day

Escitalopram, Lexapro® SSRI =10 mg/day

Citalopram, Celexa® SSRI =20 mg/day

Trazodone, Desyrel® triazolopyridine =100 mg/day

• Trials with AZILECT did not allow use of fluoxetine (Prozac®) or fluvoxamine (Luvox®)

Coadministration with antidepressants is a warning associated

with selective MAO-B inhibitors (AZILECT and DEPRENYL)

• Antidepressants are not contraindicated with AZILECT

• AZILECT labeling contains a warning regarding use with antidepressants:

“…it seems prudent, in general, to avoid the combination of AZILECT with any antidepressant.”

Be aware of the risks and use clinical judgment

• AZILECT label outlines the potential risks of an antidepressant interaction, including an

increased risk of developing serotonin syndrome

• Of 2487 patients in trials, 477 received both AZILECT and an antidepressant with no

reported serious or nonserious adverse events consistent with serotonin syndrome. However, the exposure, both in dose and number of subjects, was not adequate to rule out the possibility of an untoward reaction from combining these agents.

• In the postmarketing period, nonfatal cases of serotonin syndrome have been

reported in patients treated with antidepressants concomitantly with AZILECT

• Use caution and apply clinical judgment when using AZILECT to treat

PD patients who take an antidepressant


I have a good PD neurologist, who is very well known in the PD field in our area....He is on the panel of experts, when there is a Parkinsons symposium in my area......I should have listened and not have been "frightened off" by a "well meaning" , fellwow PD blogger.

I just wanted to state this and say, If you have a good PD neurologist, "call him or her with your concerns". I did not and it cost me many nights sleep.

7 Replies

Iit is a Parkinsons Research site, the URL is:



Bravo!!!!!! I f I do question anything, I ask my DOCTOR !!!!!!


Fantastic CJ49 - I told in my "opening sppeech" that from the time I started to use Azilect with my other drugs my life changed. I had forgotten the heartache I went through because my pharmacist (who is very thoroigh) raised the contra indication with my use of Paroxetine. I researched and researched anbd kept coming back to the Serotonin Syndrome - I wish I had researched as deeply as CJ49 . I eventually spoke to a number of Neurologists and they all said the risk was very small and so I started AZilect and have not looked back


The only thing that my Neuro made me aware of with Azilect is to not take Demoral with it! I don't, but it's a good thing to know!


I have the Azilect brochure which also includes the antibiotic Ciprofloxacin (CIPRO) because it inhibits an enzyme in your body and can cause blood levels of Azilect to double increasing the risk of side effects. Other meds listed are Demerol, Tramadol, Methadone, Darvon, Flexeril, Dextromethorphan and St. John's wort.



when I was trying Azilect, I read the pages that come with it and there were many restrictions about food: cheese and chocolate. I asked my doctor (who's a research neurologist) and he said not to worry. Unfortunately, it didn't work for me . Wish I had tried it BEFORE I went on sinemet.


Azilect was added to my meds 2 months ago. I've been on Paxil for 2 years and have had no problem taking both drugs together.



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