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Drug-drug Interactions in Psychiatric Practice, Part 1

Reasons, Importance, and Strategies to Avoid and Recognize Them

PRESKORN, SHELDON H., MD

Journal of Psychiatric Practice®: July 2018 - Volume 24 - Issue 4 - p 261–268
doi: 10.1097/PRA.0000000000000322
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This column begins a series exploring drug-drug interactions (DDIs) with a special emphasis on psychiatric medications. As explained in this column, this topic is important for multiple reasons. First, a large percentage of the population is receiving psychiatric medications. Second, these patients are likely to be on multiple medications which means that they are at risk for an adverse DDI. Third, DDIs may occur but not be recognized even though they have significant health care consequences for the patient. Fourth, these consequences can range from a catastrophic outcome to more everyday clinical problems involving a myriad of presentations as enumerated in this column. Also discussed in this column is the fact that all drugs, including psychiatric medications, interact on the basis of their pharmacodynamics and pharmacokinetics rather than their therapeutic use. Therefore, psychiatric medications may interact with medications prescribed for nonpsychiatric reasons as well as with other psychiatric medications. Tables are included that explain reasons for multiple medication use and principles to follow to minimize the risk of adverse DDIs.

PRESKORN: Kansas University School of Medicine-Wichita, Wichita, KS

This column has been adapted with permission from Appendix I in Preskorn SH. Drug-drug Interactions With an Emphasis on Psychiatric Medications, 1st ed. West Islip, NY and Durant, OK: Professional Communications; 2018. To order a copy of the book, readers can call 1-800-337-9838 or visit the Professional Communications website at: www.pcibooks.com.

S.H.P. has worked with over 135 pharmaceutical companies in the United States and throughout the world. Over the past year, he has received grants/research support from or has served as a consultant, on the advisory board, or on the speaker’s bureau for Alkermes, Allergan, Bionomics, BioXcel, Cercor, Food and Drug Administration, Janssen, National Institute of Mental Health, Merck, Novaritis, Pfizer, Rugen Holdings, and Sunovion.

Please send correspondence to: Sheldon H. Preskorn, MD, University of Kansas Medical Center, 1010 N. Kansas, Wichita, KS 67217.

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