Contraindications include prior treatment (within the past 5–6 weeks, depending on the dose) with MAOIs such as phenelzine and tranylcypromine, due to the potential for serotonin syndrome. Its use should also be avoided in those with known hypersensitivities to<unk>  or any of the other ingredients in the formulation used. Its use in those concurrently receiving pimozide or thioridazine is also advised against. In some cases, use of dextromethorphan-containing cold and cough medications with<unk>  is advised against, due to<unk>  increasing serotonin levels, as well as the fact that<unk>  is a cytochrome P450 2D6 inhibitor, which causes dextromethorphan to not be metabolized at a normal rate, thus increasing the risk of serotonin syndrome and other potential side effects of dextromethorphan. Patients who are taking anticoagulants or NSAIDS must be careful when taking<unk>  or other SSRIs, as they can sometimes increase the blood-thinning effects of these medications.<unk>  and norfluoxetine inhibit many isozymes of the cytochrome P450 system that are involved in drug metabolism. Both are potent inhibitors of CYP2D6 (which is also the chief enzyme responsible for their metabolism) and CYP2C19, and mild to moderate inhibitors of CYP2B6 and CYP2C9. In vivo,<unk>  and norfluoxetine do not significantly affect the activity of CYP1A2 and CYP3A4. They also inhibit the activity of P-glycoprotein, a type of membrane transport protein that plays an important role in drug transport and metabolism and hence P-glycoprotein substrates such as loperamide may have their central effects potentiated. This extensive effect on the body's pathways for drug metabolism creates the potential for interactions with many commonly used drugs. Its use should also be avoided in those receiving other serotonergic drugs such as monoamine oxidase inhibitors, tricyclic antidepressants, methamphetamine, amphetamine, MDMA, triptans, buspirone, serotonin–norepinephrine reuptake inhibitors and other SSRIs due to the potential for serotonin syndrome to develop as a result. There is also the potential for interaction with highly protein-bound drugs due to the potential for<unk>  to displace said drugs from the plasma or vice versa hence increasing serum concentrations of either<unk>  or the offending agent.
Fluoxetine
Atomoxetine
Duloxetine
Dapoxetine
Edivoxetine
Vortioxetine
Bupropion
Citalopram