Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-23T12:10:55.786Z Has data issue: false hasContentIssue false
  • English
  • Français

Drug-Drug Interactions with Antipsychotics

Published online by Cambridge University Press:  07 November 2014

Jonathan Meyer
Get access Rights & Permissions [Opens in a new window]

Extract

Recognizing drug-drug interactions (DDIs) has become increasingly important as the country's demographics have aged, resulting in more complex medication regimens. Budnitz and colleagues highlighted the frequency of adverse drug reactions (ADRs) and the substantial morbidity that results. Their study estimated >700,000 cases of ADRs in emergency rooms (ER) in the United States between 2004 and 2005, and that ADRs accounted for 6.7% of ER visits for unintentional injuries that led to hospitalization. Moreover, medications that require monitoring accounted for 41.5% of all the ADR-related hospitalizations.

These data have tremendous implications for the field of psychiatry because many psychiatric drugs require therapeutic monitoring. The importance of DDIs is particularly relevant for the psychiatric population, where adverse effects not only cause short-term morbidity, but may lead to long-term treatment noncompliance. For many patients taking antipsychotics, adherence is the key to a successful outcome. Minimizing DDIs maximizes the chance that people will avoid unnecessary ADRs while achieving therapeutic drug levels.

Type
Expert Roundtable Supplement
Information
CNS Spectrums , Volume 12 , Issue S21: Inpatient to Outpatient Status: Clinical Considerations in the Transitional Treatment of Schizophrenia , December 2007 , pp. 6 - 9
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Budnitz, DS, Pollock, DA, Weidenbach, KN, et al.National surveillance of emergency department visits for outpatient adverse drug events. JAMA. 2006;296(15):1858–1866.CrossRefGoogle ScholarPubMed
2.Clark, RE, Bartels, SJ, Mellman, TA, Peacock, WJ. Recent trends in antipsychotic combination therapy of schizophrenia and schizoaffective disorder: implications for state mental health policy. Schizophr Bull. 2002;28(1):75–84.Google Scholar
3.Chakos, MH, Glick, ID, Miller, AL, et al.Baseline use of concomitant psychotropic medications to treat schizophrenia in the CATIE trial. Psychiatr Serv. 2006;57(8):1094–1101.CrossRefGoogle ScholarPubMed
4.Lizer, MH, Brackbill, ML. Medication history reconciliation by pharmacists in an inpatient behavioral health unit. Am J Health Syst Pharm. 2007;64(10): 1087–1091.Google Scholar
5.Cozza, KL, Armstrong, SC, Oesterheld, JR. Concise Guide to Drug Interaction Principles for Medical Practice: Cytochrome P450s, Ugts, P-Glycoproteins. 2nd ed. Washington, DC: American Psychiatric Press, Inc.; 2003.Google Scholar
6.Richelson, E. Pharmacokinetic drug interactions of new antidepressants: a review of the effects on the metabolism of other drugs. Mayo Clin Proc. 1997;72(9):835–847.Google Scholar
7.Olesen, OV, Linnet, K. Contributions of five human cytochrome P450 isoforms to the N-demethylation of clozapine in vitro at low and high concentrations. J Clin Pharmacol. 2001;41:823–832.CrossRefGoogle Scholar
8.Meyer, JM. Individual changes in clozapine levels after smoking cessation: results and a predictive model. J Clin Psychopharmacol. 2001:21(6):569–574.Google Scholar
9.Preskorn, SH, Flockhart, D. 2006 Guide to psychiatric drug interactions. Primary Psychiatry. 2006:13:35–64.Google Scholar
10.Flockhart, DA. Available at: http://medicine.iupui.edu/flockhart/table.htm. Accessed September 21, 2007.Google Scholar
11. Abilify [Package Insert]. Princeton, NJ: Bristol-Myers Squibb; 2006.Google Scholar
12. Clozaril [Package Insert]. East Hanover, NJ: Novartis Pharmaceuticals; 2005.Google Scholar
13. Zyprexa [Package Insert]. Indianapolis, IN: Eli Lilly; 2006.Google Scholar
14.Joos, AA, König, F, Frank, UG, et al.Dose-dependent pharmacokinetic interaction of clozapine and paroxetine in an extensive metabolizer. Pharmacopsychiatry. 1997;30(6):266–270.Google Scholar
15.Olesen, OV, Linnet, K. Fluvoxamine-Clozapine drug interaction: inhibition in vitro of five cytochrome P450 isoforms involved in clozapine metabolism. J Clin Psychopharmacol. 2000;20(1):35–42.CrossRefGoogle ScholarPubMed
16.Rostami-Hodjegan, A, Amin, AM, et al.Influence of dose, cigarette smoking, age, sex, and metabolic activity on plasma clozapine concentrations: a predictive model and nomograms to aid clozapine dose adjustment and to assess compliance in individual patients. J Clin Psychopharmacol. 2004;24(1):70–78.CrossRefGoogle ScholarPubMed
17.Seroquel [Package Insert]. Wilmington, Del: AstraZeneca Pharmaceuticals LP; 2005.Google Scholar
18.DeVane, CL, Nemeroff, CB. Clinical pharmacokinetics of quetiapine: an atypical antipsychotic. Clin Pharmacokinet. 2001;40(7):509–522.CrossRefGoogle ScholarPubMed
19.Risperdal [Package Insert]. Titusville, NJ: Janssen Pharmaceutica; 2006.Google Scholar
20.Wong, YW, Yen, C, Thyrum, PT. The effects of concomitant phenytoin administration on the steady-state pharmacokinetics of quetiapine. J Clin Psychopharmacol. 2001;21(1):89–93.Google Scholar
21.Spina, E, Avenoso, A, Scordo, MG, et al.Inhibition of risperidone metabolism by fluoxetine in patients with schizophrenia: a clinically relevant pharmacokinetic drug interaction. J Clin Psychopharmacol. 2002;22(4):419–423.Google Scholar
22. Invega [Package Insert]. Titusville, NJ: Janssen Pharmaceutica; 2006.Google Scholar
23. Geodon [Package Insert]. New York, NY: Pfizer Inc., 2006.Google Scholar
24.Preskorn, SH. Drug-drug interactions: proof of relevance (part II) cause of tolerability problems or noncompliance. J Psychiatr Pract. 2005;11(6):397–401.Google Scholar