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

  • Psychiatry in Primary Care (BN Gaynes, Section Editor)
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Abstract

In recent years, the growing numbers of patients seeking care for a wide range of psychiatric illnesses in the primary care setting has resulted in an increase in the number of psychotropic medications prescribed. Along with the increased utilization of psychotropic medications, considerable variability is noted in the prescribing patterns of primary care providers and psychiatrists. Because psychiatric patients also suffer from a number of additional medical comorbidities, the increased utilization of psychotropic medications presents an elevated risk of clinically significant drug interactions in these patients. While life-threatening drug interactions are rare, clinically significant drug interactions impacting drug response or appearance of serious adverse drug reactions have been documented and can impact long-term outcomes. Additionally, the impact of genetic variability on the psychotropic drug’s pharmacodynamics and/or pharmacokinetics may further complicate drug therapy. Increased awareness of clinically relevant psychotropic drug interactions can aid clinicians to achieve optimal therapeutic outcomes in patients in the primary care setting.

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Acknowledgments

This work was supported by a grant from National Institutes of Health (T32 HL087738).

Disclosure

Drs. English and Jhee reported no potential conflicts of interest relevant to this article.

Dr. Dortch has served as a consultant to Ortho McNeil, and has received honoraria for serving on an expert panel for Sanofi and American Society of Health-System Pharmacists.

Dr. Ereshefsky has served as a board member for International Society for CNS Clinical Trials and Methodology (ISCTM), has received compensation for development of educational presentations from CPAP and Merck & Co.

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Authors and Affiliations

  1. Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN, 37232-8300, USA

    Brett A. English

  2. Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, TN, 37232-8300, USA

    Brett A. English

  3. Center for Neuroscience Drug Discovery, Vanderbilt University School of Medicine, Nashville, TN, 37232-8300, USA

    Brett A. English

  4. Department of Pharmaceutical Services, Vanderbilt University School of Medicine, Nashville, TN, 37232-8300, USA

    Marcus Dortch

  5. PAREXEL International, Glendale Adventist Medical Center, 1560 E. Chevy Chase Drive, Glendale, CA, 91206, USA

    Brett A. English, Larry Ereshefsky & Stanford Jhee

  6. California Clinical Trials, Glendale, CA, USA

    Larry Ereshefsky & Stanford Jhee

  7. University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    Larry Ereshefsky

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  1. Brett A. English
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  2. Marcus Dortch
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  4. Stanford Jhee
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Correspondence to Brett A. English.

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English, B.A., Dortch, M., Ereshefsky, L. et al. Clinically Significant Psychotropic Drug-Drug Interactions in the Primary Care Setting. Curr Psychiatry Rep 14, 376–390 (2012). https://doi.org/10.1007/s11920-012-0284-9

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