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Titolo:
CLINICALLY SIGNIFICANT INTERACTIONS OF PSYCHOTROPIC AGENTS WITH ANTIPSYCHOTIC-DRUGS
Autore:
MEYER MC; BALDESSARINI RJ; GOFF DC; CENTORRINO F;
Indirizzi:
MASSACHUSETTS GEN HOSP,DEPT PSYCHIAT,DIV CHILD PSYCHIAT,ACC-725 BOSTON MA 02114 HARVARD UNIV,SCH MED,DEPT PSYCHIAT BOSTON MA 02115
Titolo Testata:
Drug safety
fascicolo: 5, volume: 15, anno: 1996,
pagine: 333 - 346
SICI:
0114-5916(1996)15:5<333:CSIOPA>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEUROLEPTIC MALIGNANT SYNDROME; CHRONIC-SCHIZOPHRENIC PATIENTS; REDUCED HALOPERIDOL CONCENTRATIONS; CARBAMAZEPINE-INDUCED REDUCTION; ANTI-PARKINSONIAN MEDICATION; PLASMA-LEVELS; SERUM CONCENTRATIONS; LITHIUM-CARBONATE; EXTRAPYRAMIDAL SYMPTOMS; ANTICHOLINERGIC DRUGS;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
199
Recensione:
Indirizzi per estratti:
Citazione:
M.C. Meyer et al., "CLINICALLY SIGNIFICANT INTERACTIONS OF PSYCHOTROPIC AGENTS WITH ANTIPSYCHOTIC-DRUGS", Drug safety, 15(5), 1996, pp. 333-346

Abstract

Various psychotropic drugs are commonly combined with antipsychotic agents. Such combinations can induce pharmacodynamically based, presumably additive, beneficial (e.g. sedative or mood-altering) effects or adverse autonomic, cardiac depressant and CNS intoxicating effects. Clinically significant interactions also arise through competition with or induction of hepatic microsomal cytochrome P450 (CYP) enzymes, particularly the CYP1A2 and CYP2D6 isozymes by which most antipsychotics are oxidised. Such pharmacokinetic interactions can elevate circulating concentrations of antipsychotics (both typical agents and the atypicalantipsychotic clozapine) to potentially toxic ranges, which may lead to increased risks of adverse effects. Such interactions occur particularly with serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitor antidepressants. Metabolic interactions that lead to lesser increases inantipsychotic concentrations may arise in combining these drugs with other antidepressants, benzodiazepines or propranolol. In contrast, most anticonvulsants, except valproic acid (sodium valproate), induce the oxidative metabolism of antipsychotics and can lower their plasma concentrations to potentially subtherapeutic levels, with unpredictable increases after their discontinuation. Since simultaneous use of multiple psychotropic agents is increasingly common, special caution is required to avoid untoward consequences of interactive adverse effects due to drug interactions, which can sometimes be severe or life-threatening.

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Documento generato il 25/01/20 alle ore 10:00:26