This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pharmacology
Which of the following if combined with Rivastigmine, 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.