Meperidine has a potentially lethal interaction with MAO inhibitors.

Meperidine has a potentially lethal interaction with MAO inhibitors.

• A. True
• B. False
• C. Only with SSRIs
• D. Prevents MAOI action

Answer: (A)

Meperidine and MAO inhibitors interact in a dangerous way because both affect brain monoamines, especially serotonin. MAO inhibitors block the breakdown of serotonin, norepinephrine, and dopamine, so their levels in the synapse rise. Meperidine has serotonergic activity and can promote serotonin release. When used together, this pushes serotonin (and other monoamines) to levels that can trigger serotonin syndrome, a potentially life-threatening condition marked by confusion, agitation, autonomic instability, tremor or myoclonus, hyperreflexia, hyperthermia, and can progress to coma or death. For this reason, combining meperidine with MAO inhibitors is avoided. Saying it’s only a problem with SSRIs isn’t correct because MAO inhibitors alone raise monoamine levels and, with meperidine’s serotonergic effect, the risk is already present. It doesn’t block or prevent MAOI action; it adds to the risk rather than interfering with MAOI activity.

Meperidine and MAO inhibitors interact in a dangerous way because both affect brain monoamines, especially serotonin. MAO inhibitors block the breakdown of serotonin, norepinephrine, and dopamine, so their levels in the synapse rise. Meperidine has serotonergic activity and can promote serotonin release. When used together, this pushes serotonin (and other monoamines) to levels that can trigger serotonin syndrome, a potentially life-threatening condition marked by confusion, agitation, autonomic instability, tremor or myoclonus, hyperreflexia, hyperthermia, and can progress to coma or death. For this reason, combining meperidine with MAO inhibitors is avoided.

Saying it’s only a problem with SSRIs isn’t correct because MAO inhibitors alone raise monoamine levels and, with meperidine’s serotonergic effect, the risk is already present. It doesn’t block or prevent MAOI action; it adds to the risk rather than interfering with MAOI activity.