Which of the following if combined with Rivastigmine, 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.