What medication should be discontinued for two weeks before starting Fluoxetine?

The medication that should be discontinued for two weeks before starting Fluoxetine is Phenelzine. This is due to the potential for a serious drug interaction between Fluoxetine, which is a selective serotonin reuptake inhibitor (SSRI), and Phenelzine, which is a monoamine oxidase inhibitor (MAOI).

When Fluoxetine is administered alongside an MAOI such as Phenelzine, there is a risk of serotonin syndrome, a potentially life-threatening condition resulting from excess serotonin in the brain. By ensuring that Phenelzine is discontinued at least two weeks before initiating Fluoxetine, the risk of this severe interaction is significantly reduced, allowing for a safer transition between these two classes of medications.

The other medications listed, such as Sertraline, Citalopram, and Trazodone, do not require this precaution when transitioning to Fluoxetine, as they are either within the same SSRI class or act differently and have different interaction profiles. Thus, the focus on discontinuing Phenelzine specifically highlights the importance of managing drug interactions carefully in psychiatric medication management.