An overview of psychotropic drug-drug interactions.

  title={An overview of psychotropic drug-drug interactions.},
  author={Neil B. Sandson and Scott C. Armstrong and Kelly L. Cozza},
  volume={46 5},
The psychotropic drug-drug interactions most likely to be relevant to psychiatrists' practices are examined. The metabolism and the enzymatic and P-glycoprotein inhibition/induction profiles of all antidepressants, antipsychotics, and mood stabilizers are described; all clinically meaningful drug-drug interactions between agents in these psychotropic classes, as well as with frequently encountered nonpsychotropic agents, are detailed; and information on the pharmacokinetic/pharmacodynamic… 

A current review of cytochrome P450 interactions of psychotropic drugs.

Psychotropic drugs may interact with other prescribed medications used to treat concomitant medical illnesses and patient education will help reduce the likelihood of potentially fatal drug-drug interactions.

Biological perspectives psychiatric drug-drug interactions: a review.

Basic drug–drug interaction principals are proposed that can serve to guide practice by presenting foundational concepts to bolster that ever-important critical thinking component of prescriptive care.

Clinically Significant Psychotropic Drug-Drug Interactions in the Primary Care Setting

Increased awareness of clinically relevant psychotropic drug interactions can aid clinicians to achieve optimal therapeutic outcomes in patients in the primary care setting.

CYP450 and Its Implications in the Clinical Use of Antipsychotic Drugs

Choosing drugs with low interaction potential seems to be the best strategy to prevent clinically relevant interactions particularly in elderly, polymedicated, oncologic and HIV patients.

A Review of Drug Interactions With Psychiatric Medicines for the Pharmacy Practitioner

This review identifies drug interactions that may occur with the most frequently prescribed psychiatric medications and provides a review of selected interactions that might be clinically relevant for the pharmacist to review.

The Pharmacological Role and Clinical Applications of Antipsychotics' Active Metabolites: Paliperidone versus Risperidone

The pharmacological differences between risperidone and paliperidone could explain the differential clinical response exhibited by schizophrenic patients treated with both agents, as well as some differences in tolerability profile and drug interactions.

Applied clinical pharmacokinetics and pharmacodynamics of psychopharmacological agents

Dose and regimen selection must also take drug interactions, genetic polymorphisms, comorbid conditions, and aging into account since all of these can impact drug exposure, effi cacy, and toxicity.


The more psychiatric drugs a patient is taking, the risk for injurious DDIs and cumulative toxicity is greater and all interactions cannot provide but if possible, should be avoided for complicated therapeutic schemes.

Interactions between valproic acid and quetiapine/olanzapine in the treatment of bipolar disorder and the role of therapeutic drug monitoring

The main objective of this paper is to review the incidence of DDIs between the anticonvulsant and the antipsychotics, to postulate the possible mechanisms of the interaction and to establish whether certain target populations are at an increased susceptibility to such interactions.

Exposure to potentially dangerous drug-drug interactions involving antipsychotics.

Interventions by physicians and pharmacies to reduce the prescribing and dispensing of potentially harmful pairs of medications to patients with schizophrenia are recommended.



Selective Serotonin Reuptake Inhibitors and CNS Drug Interactions

In vitro and in vivo evidence for drug interactions between SSRIs and other central nervous system drugs is reviewed, with special emphasis on antipsychotics, tricyclic anti-depressants and benzodiazepines.

An Evaluation of Risperidone Drug Interactions

Controlled studies and case reports indicate that risperidone has a low potential for metabolic drug interactions, and adherence to a few guidelines for the design of dosage regimens should limit the effect of drug-drug interactions on patient status and contribute to optimal pharmacotherapy with ris peridone.

Clinical Significance of Pharmacokinetic Interactions Between Antiepileptic and Psychotropic Drugs

Serum level monitoring of AEDs and psychotropic drugs can be useful in determining the need for dosage adjustments, especially if there is any change in seizure control, or possible toxicity, as well as predicting and avoiding clinically significant interactions.

New Antiepileptic Drugs: Review on Drug Interactions

These newer antiepileptic drugs exhibit a lower potential for drug interactions than the classic AEDs, like phenytoin, carbamazepine and valproic acid, mostly because of their pharmacokinetic characteristics.

Pharmacologic interactions between valproate and other drugs.

  • B. Bourgeois
  • Medicine, Biology
    The American journal of medicine
  • 1988

Fluvoxamine. A review of global drug-drug interaction data.

Clinical symptoms were infrequent and varied widely; no symptom clusters were identified; those agents metabolised by cytochrome P450 1A2 isoenzyme appear most likely to be involved in drug-drug interactions with fluvoxamine.

The Effects of Concomitant Phenytoin Administration on the Steady-State Pharmacokinetics of Quetiapine

D dosage adjustment of quetiapine may be necessary when the two drugs are given concurrently and that caution may be required when administering other drugs that inhibit or induce cytochromes, particularly P450 3A4.

Clinically Significant Pharmacokinetic Drug Interactions with Carbamazepine

Avoidance of unnecessary polypharmacy, selection of alternative agents with lower interaction potential, and careful dosage adjustments based on serum drug concentration monitoring and clinical observation represent the mainstays for the minimisation of risks associated with these interactions.

Significant reduction of sertraline plasma levels by carbamazepine and phenytoin

The observed low levels of sertraline are probably explained by CYP induction, especially of CYP3A4, which is the quantitatively most important CYP in human liver.

Paroxetine shifts imipramine metabolism