Which of the following if combined with rivastagmine,decreases its efficacy?: (A) Selective serotonin reuptake inhibitors, (B) Reversible inhibitor of MAO-A, (C) Tricyclic antidepressants, (D) Atypical antidepressants
Answer is C. *Rivastigmine is used in Alzheimer's disease. It inhibits acetylcholinesterase and increases the level of ACh. *Tricyclic antidepressants have strong anticholinergic actions.Therefore,these can reduce the efficacy of rivastigmine. Depression is commonly seen in patients with Alzheimer's disease. The anti-depressants that are used should have minimum anticholinergic activity, therefore SSRI or MAO-inhibitors are preferred. Ref: KATZUNG 14TH ED.