American Board of Psychiatry and Neurology (ABPN) Practice Exam 2025 – Comprehensive All-in-One Guide to Exam Success!

Levodopa/carbidopa is a primary treatment for Parkinson's disease, and it works by replenishing dopamine levels in the brain. When initiating therapy with levodopa/carbidopa, it is crucial to consider drug interactions and contraindications.

Tranylcypromine is a monoamine oxidase inhibitor (MAOI) that can pose significant risks when combined with levodopa/carbidopa. The interaction can lead to hypertensive crises or serotonin syndrome, both of which can be severe and life-threatening. This is especially true if the MAOI is not discontinued prior to starting dopaminergic therapy, as the combination can excessively increase catecholamine levels, resulting in dangerous side effects.

In contrast, the other medications listed, such as amitriptyline (a tricyclic antidepressant), fluoxetine (an SSRI), and gabapentin (used primarily for neuropathic pain), do not have the same level of contraindication. These medications can generally be used in patients starting levodopa/carbidopa therapy, though monitoring for side effects or potential interactions might still be warranted, particularly with amitriptyline given its anticholinergic properties.

Thus, the serious interaction potential with tranylcyp