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[Pharmacokinetic Problems with Psychotropic Drug Combination Therapy]
Seishin Shinkeigaku Zasshi = Psychiatria Et Neurologia Japonica
|January 9, 2019
Summary
Drug pharmacokinetics differ between patients and can change over time, especially with drug interactions. Combining multiple medications, particularly psychotropic drugs, complicates effects and is not recommended due to pharmacokinetic variability.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Drug Metabolism
Background:
- Patient-specific pharmacokinetics significantly influence drug efficacy and safety.
- Drug interactions are a common cause of pharmacokinetic variability within individuals.
- Psychotropic medications exhibit complex pharmacokinetic profiles, affecting co-administered drugs.
Purpose of the Study:
- To highlight the pharmacokinetic variability of drugs in patients.
- To explain how drug interactions, particularly with psychotropic drugs, alter drug levels.
- To advise against multidrug combination therapy based on pharmacokinetic principles.
Main Methods:
- Review of pharmacokinetic principles related to drug interactions.
- Analysis of psychotropic drug interactions involving plasma protein binding and enzyme metabolism.
- Assessment of the complexity introduced by polypharmacy.
Main Results:
- Psychotropic drugs can increase or decrease blood levels of concomitant medications.
- High plasma protein binding of psychotropic drugs can potentiate other drug effects.
- Increased number of drugs leads to more complex and unpredictable pharmacokinetic interactions.
Conclusions:
- Multidrug combination therapy presents significant pharmacokinetic challenges.
- Predicting clinical effects in polypharmacy is difficult due to complex drug interactions.
- Pharmacokinetic considerations advise against routine multidrug combination therapy.
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