2004 Guide to Psychiatric Drug Interactions

Sheldon H. Preskorn, David Flockhart

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations


Why should physicians be concerned about drug-drug interactions (DDIs)? DDIs have the potential for causing untoward outcomes, including morbidity and even mortality for the patient, liability for the prescriber, and increased costs for the healthcare system. The risk of unintended and untoward DDIs is increasing in concert with both the increasing number of pharmaceuticals available and the number of patients on multiple medications. A recent survey found that 10% of all Americans >18 years of age were taking five or more prescription medications. Additional studies have found that patients on psychiatric medications, such as antidepressants, are on more medications than patients not on psychiatric medication. In addition, medications interact not on the basis of their therapeutic use but on the basis of their pharmacodynamics and pharmacokinetics. For these reasons, the prescriber of psychiatric medications must consider all of the medications the patient is taking. This educational review discusses major pharmacologic principles to guide the safe and effective use of multiple medications with a focus on neuropsychiatric medications. It also presents tables outlining major pharmacodynamic and pharmacokinetic mechanisms mediating DDIs relevant to the patient on psychiatric medications.

Original languageEnglish (US)
Pages (from-to)39-60
Number of pages22
JournalPrimary Psychiatry
Issue number2
StatePublished - Feb 1 2004

ASJC Scopus subject areas

  • Psychiatry and Mental health

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