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At least 19 recordsLinked to original sources

Neurologic drug-psychotropic drug update.

It is essential that both the neurologist and the psychiatrist be aware of the neurology drug-psychotropic drug interactions because neurologists prescribe many psychotropic medications and psychiatric consultants often recommend the use of psychotropic drugs for neurology patients. Six methods of examining drug-drug interactions were employed: 1) PubMed (MEDLINE); 2) Hanston's Drug Interaction Analysis and Management Text (July 2001 quarterly updated version); 3)Drug Interactions Facts (quarterly updated version through July 2001); 4) Micromedex Drug-dex; 5) American Hospital Formulary Service Drug Information; 6) Food and Drug Administration (MedWatch) Dear Doctor Letters and new labeling. Over eighty important interactions of significance level 1 (major), or significance level 2 (minor) were found. Furthermore, over one-third of the neurologist's most commonly administered medications were those also employed by the psychiatrist, but not necessarily for the same reason, e.g., carbamazepine, for seizure control (neurologist) or mood stabilization (psychiatrist).

Brain Diseases↗

Cardiac drug-psychotropic drug update.

This is an update from the report-Cardiac Drug and Psychotropic Drug Interactions: Significance and Recommendations-published in this journal in November-December 1999. As mentioned in that article there has been an explosion of new drugs both in psychiatry and cardiology without a sufficient understanding of their potential interactions. Also there is a need for methods to update drug interactions on an ongoing basis. This report describes: 1) examples of actual adverse interactions from clinical cases that move beyond some of the hypothesized contraindications included in the 2000 millennium publication; 2) confirmation of previous adverse interactions reported if they strengthen the earlier findings; 3) listing of new drugs, e.g., sildenafil (viagra) now commonly prescribed by psychiatrists and cardiologists; 4) reports explaining and/or refining mechanisms of adverse interactions; and 5) cautions and important associated phenomenon of either a cardiac or a psychotropic drug, e.g., valproic acid and cases of life-threatening pancreatitis. Methods of publicizing the new knowledge of cardiac drug-psychotropic drug interactions, e.g., the Internet and web sites are described.

Cardiovascular Agents↗

On the non-specific antiinflammatory effects of other-than-antirheumatic drugs. Psychotropic drugs, inflammation and antiinflammatory drugs.

The interference of non-antiinflammatory drugs with inflammation and with the effects of antiinflammatory/antirheumatic drugs (AIDs) is exemplified by various psychotropic drugs (PTDs). The antiinflammatory action was evaluated in 3 ways: (i) drug effects on bentonite raw-paw oedema after a prophylactic and a therapeutic dose in the same rat, (ii) effect on bentonite oedema of single and repeated administrations (oedema induction in the contralateral paw 7 days later, drug administration continued in the interim), and (iii) effects on traumatic rat-ear oedema of single and repeated pretreatment. Most of the PTDs tested (neuroleptics, anxiolytics, psychostimulants, etc.) suppressed significantly the acute oedema, and some of them (caffeine, nomifensine, lisuride, etc.) also suppressed the fully developed oedema. Many PTDs, when given repeatedly, lost their effects or even aggravated the later phase of inflammation. PTDs can interfere also with the antiinflammatory effects of AIDs, since caffeine and guaifenesin, but not nomifensine, increased the antiinflammatory effects of aspirin and paracetamol, although neither caffeine nor nomifensine interfered with the effect of Auranofin. Therefore in clinical practice the interference of PTDs must be taken account: a PTD taken by the patient can mask signs of acute inflammation (including posttraumatic and postsurgical states). Moreover, the antiinflammatory potential of various analgesic/antipyretic combinations containing a PTD should be considered in view of this interference, since this can sometimes be exploited therapeutically.

Animals↗

Comparison of three methods for identifying medical drug-psychotropic drug interactions.

Three methods for examining drug-drug interactions were compared to understand advantages and disadvantages of each: ePocrates; Interact; The Mount Sinai multiple source for the evaluation of drug-drug interactions (MS). ePocrates is a commonly employed software system utilized in a hand held computer, the PalmPilot. Interact is on a CD-ROM, and promoted by the American Psychiatric Association Press. The MS system was developed by the authors and utilizes six separate references sources to ascertain the presence and significance of drug-drug interactions. Commonly prescribed neurology and psychotropic medication interactions were compared using the three systems. ePocrates did not list the significance level of the interaction, e.g., (major, moderate, minor), often did not include a mechanism of action, and several commonly employed medications were not included. It did permit examining several drugs at the same time, and was easily carried on the person of the physician. Interact often contained old references, several drugs were not included, was not adapted to a hand held computer format, and had no update since 1999. The MS system listed level of significance, provided mechanism of action, and advice to the practitioner including recommendations. It is not portable, requiring a laptop or desk top computer or hard copy, and only searches one drug at a time. It is hoped that the advantages of each of these three systems may be incorporated into systems of the future.

Central Nervous System Agents↗

Psychotropic drug versus psychotropic drug-update.

Psychotropic drugs are not necessarily the drugs of psychiatry. Seventy percent of antidepressants, and 90% of anxiolytics are prescribed by nonpsychiatric physicians. Since psychotropic medications are so frequently employed by nonpsychiatric physicians, e.g., neurologists, primary care physicians, internists, and because large numbers of their patients are concurrently on medical drugs for somatic reasons, the interactions of psychotropic versus medical drugs and psychotropic versus psychotropic drugs as listed below must be understood before primary care physicians or psychiatrists prescribe psychotropic medications, especially to the medically ill. Seventy commonly prescribed psychotropic drugs were examined for their interactions with other psychotropic medications using six reference tools: 1) MEDLINE (PubMed) employing the first generic psychotropic drug name, the second generic psychotropic drug name, and the term "interaction;" 2) Hanston's Drug Interaction Analysis and Management Text (quarterly updated version); 3) Drug Interactions Facts (Facts and Comparisons) (July 2001 quarterly updated version); 4) Micromedex Drug-dex; 5) American Hospital Formulary Service Drug Information; and 6) Food and Drug Administration (MedWatch) (Dear Doctor Letters and new labeling) ( for (1999, 2000, and 2001). The authors recognized that all of the above sources do not necessarily cover the entire information database regarding drug-drug interactions. (Citations regarding children, reports in foreign languages or concerning food, animals, in vitro experiments, analgesics, and naturalistic-herbal or natural products-treatment interactions were excluded).

Drug Interactions↗

Adverse cutaneous reactions to psychotropic drugs.

Psychotropic drugs are frequently used in both psychiatric and general medical practice. Familiarity with common side effects and their management may assist psychiatrists in the selection of agents to suit individual patient needs. The authors describe the morphologic features and pathologic basis of cutaneous reactions to drugs and discuss the common and reported cutaneous side effects of psychotropic drugs. Although most dermatologic reactions to drugs follow a benign course after drug discontinuation, more serious effects are known to occur with certain agents. An overview of the diagnosis and management of these adverse drug reactions is provided.

Adverse Drug Reaction Reporting Systems↗

[Endocrinologic adverse effects of psychotropic drugs].

Psychotropic drugs affect the regulatory mechanisms of different neuroendocrine axis. This chapter reviews the interactions between psychotropic drugs and prolactin, the hypothalamic-pituitary-thyroid axis and the hypothalamic-pituitary-gonadal axis. Hyperprolactinemia can cause galactorrhea, amenorrhea, sexual disfunction, impaired spermatogenesis and increased risk for osteoporosis and fractures. Atypical antipsychotics cause less hyperprolactinemia than conventional antipsychotics. Lithium has important effects on thyroid function. During lithium treatment, affectively ill patients show, in varying degrees and combinations, reduced levels of thyroid hormones and clinical evidence of subclinical hypothyroidism, overt hypothyroidism and goiter. Recent literature reports suggest that valproic acid, may be associated with polycistic ovarian syndrome. Until additional data is available, women starting valproate therapy should be warned about the possibility of endocrinology side effects.

Endocrine System Diseases↗

Effects of anesthesia on patients taking psychotropic drugs.

Psychotropic drugs, often given in combination with each other or with other nonpsychiatric drugs, generally exert profound effects on central and peripheral neurotransmitter and ionic mechanisms. Hence, prior intake of these drugs is an important consideration in the management of the patient about to undergo anesthesia and surgery. This article reviews the effects of anesthetics on patients taking antipsychotics, tricyclic antidepressants, monoamine oxidase inhibitors, and lithium carbonate.

Anesthesia↗

Clinically important examples of drug interaction. Psychotropic drugs (1). Interaction between centrally acting drugs in man: some general considerations.

As a biological phenomenon the interaction between drugs may be viewed in ;explanatory' or ;empirical' terms. In clinical psychopharmacology the former is rarely possible: two examples are cited, one concerning amphetamine and reserpine, the other desmethyl-imipramine and tetrabenazine. Among centrally acting substances, empirical studies of the interaction between alcohol and the barbiturates have been pursued intensively by several methods in clinic and laboratory. Both general considerations and recent work on the effects of amphetamine-barbiturate combinations suggest caution in the medical use of mixtures of psychotropic drugs. Adverse reactions caused by interaction between psychotropic drugs and other substances have still to be studied systematically as a potential hazard.

Amphetamine↗

Cardiac drug and psychotropic drug interactions: significance and recommendations.

Understanding cardiac drug interactions with concurrent psychotropic prescriptions is essential for the practicing cardiologist, primary care physician, and psychiatrist. There has been an explosion in the use of new drugs in both psychiatry and cardiology without widespread knowledge of their potential interactions. The increasing tendency toward polypharmacy, the use of psychotropic medications by cardiologists and primary care physicians caring for cardiac patients, and the growth of the aging population present major challenges for the practitioner. Finally, there is a need to have models and paradigms for predicting potential drug interactions-the cytochrome P450 schema. This article describes a method to identify, understand, and codify the interactions between psychotropic and cardiac drugs, a systematic approach for updating this key database, and specific cardiac-psychotropic drug interactions. Specifically, this paper 1) details the interactions, 2) addresses the level of their clinical significance, 3) describes the potential mechanism(s) of the interactions, and 4) offers recommendations to the clinician (Appendix). Because the majority of the original clinical trials, either for cardiac medications or for psychotropic drugs, did not include studies comparing these two drug domains contemporaneously, their interactions often become known only with their combined use in the clinical arena, using the patient as "guinea pig" and through subsequent reporting.

Animals↗

Cardiac drug and psychotropic drug interactions: significance and recommendations.

Understanding cardiac drug interactions with concurrent psychotropic prescriptions is essential for the practicing cardiologist and primary care physician, as well as for the psychiatrist. There has been an explosive use of new drugs in both psychiatry and cardiology without widespread knowledge of their potential interactions. The increasing tendency toward poly-pharmacy, the use of psychotropic medications by cardiologists and primary care physicians caring for cardiac patients, and the growth of the aging population present major challenges for the practitioner. Finally, there is a need to have models/paradigms for predicting potential drug interactions--e.g., the Cytochrome p450 schema. This paper describes a method to identify, understand, and codify the interactions between psychotropic and cardiac drugs, a systematic approach for updating this key database and specific cardiac-psychotropic drug interactions. Specifically, this paper 1) details the interactions, 2) addresses the level of their clinical significance, 3) describes the potential mechanism(s) of the interactions, and 4) offers recommendations to the clinician. Since the majority of the original clinical trials, either for cardiac medications or psychotropic drugs, do not include studies comparing these two drug domains contemporaneously, their interactions often become known only with their combined use in the clinical arena, using the patient as "guinea pig," and through subsequent reporting.

Cardiovascular Agents↗

[Drug dependence and psychotropic drugs].

Although the utility of psychotropic drugs has been well demonstrated, caution must still be exercised in their use. Among their potential risks, drug dependency must be kept in mind. This risk is well accepted with regard to benzodiazepines, and it appeared useful to study the potential risk for antidepressants, neuroleptics and thymoregulatory agents. Whatever the drug, the predominant factor appears to be psychological dependency. Prevention of drug dependency is most often achieved by informing the patient, limiting the length of use of the drug, making regular reevaluation of symptoms and of drug indication, and frequently be establishing a "treatment contract". The importance of the patient-physician relationship in the prescription of such treatment must be underlined.

Anti-Anxiety Agents↗

A survey of psychotropic drug prescribing.

Psychotropic drug prescribing in a group practice was studied retrospectively. Approximately two-thirds of patients considered to have psychosocial problems were being treated with psychotropic drugs. Compared with the remaining patients with psychosocial problems not prescribed psychotropic medication these patients were more likely to be older, to have no children in the household and to have a past history of physical illness but were less likely to have an acute physical problem or to have a social factor contributing to their mental problem. Sedative and antidepressant drugs were prescribed with similar frequency for all age groups but 75% of hypnotic drugs were prescribed for the elderly.The study provides evidence that while a high proportion of patients with psychosocial problems receive a prescription for a psychotropic drug, general practitioners are discriminating in their prescribing.

Adolescent↗