Drug interactions
Lithium + Selegiline
Severity: Major
Lithium and Selegiline: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both lithium and selegiline can enhance serotonergic activity, and cases of serotonin toxicity have been reported when MAO inhibitors are combined with serotonergic agents. Risk is greater with higher selegiline doses or the transdermal route at higher strengths, and symptoms include agitation, tremor, hyperthermia and neuromuscular excitability.
What this interaction means in plain words
Lithium and Selegiline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Lithium belongs to Central Nervous System; Selegiline belongs to Central Nervous System.
Why it happens
Additive serotonergic effects, with lithium enhancing serotonin neurotransmission alongside MAO inhibition by selegiline.
What to do
Monitor closely for features of serotonin syndrome, particularly after dose changes, and use the lowest effective selegiline dose. Stop one or both drugs if toxicity emerges.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Other interactions of Selegiline
- Amitriptyline + Selegiline Contraindicated
- Amoxapine + Selegiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
- Benzphetamine + Selegiline Contraindicated
- Brimonidine + Selegiline Contraindicated
- Buprenorphine long-acting + Selegiline Contraindicated
Frequently asked questions
Can I take Lithium with Selegiline?
MediHelp rates the interaction as major. Lithium and Selegiline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both lithium and selegiline can enhance serotonergic activity, and cases of serotonin toxicity have been reported when MAO inhibitors are combined with serotonergic agents. Risk is greater with higher selegiline doses or the transdermal route at higher strengths, and symptoms include agitation, tremor, hyperthermia and neuromuscular excitability.
How serious is the interaction between Lithium and Selegiline?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor closely for features of serotonin syndrome, particularly after dose changes, and use the lowest effective selegiline dose. Stop one or both drugs if toxicity emerges.
What other medicines interact with Lithium?
MediHelp also lists interactions of Lithium with, for example, Thioridazine, Vandetanib, Aceclofenac. The full list is on the Lithium page.
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