This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Central Nervous system, Subject name: Pharmacology
Which of the following if combined with rivastagmine,decreases its efficacy? 
Select and explain. 
A. Selective serotonin reuptake inhibitors, B. Reversible inhibitor of MAO-A, C. Tricyclic antidepressants, D. Atypical antidepressants
C: Tricyclic antidepressants
Answer: C: Tricyclic antidepressants 
Explanation: *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.