2010 guide to psychiatric drug interactions

Sheldon H. Preskorn, David Flockhart

Research output: Contribution to journalReview article

31 Scopus citations


Drug-drug interactions (DDIs) are a concern for the prescriber because they have the potential for causing untoward outcomes for everyone involved: morbidity 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. Based on the 2004 Health and Human Services report, 7% of Americans >18 years of age and >20% of Americans >65 years of age had taken ≥5 prescription medications in the week preceding the survey. Patients on psychiatric medications, such as antidepressants, are on more medication than patients not on psychiatric medications. Prescribers should appreciate that medications interact not on the basis of their therapeutic use, but on the basis of their pharmacodynamics and pharmacokinetics. For this reason, the prescriber of psychiatric medications must consider all of the medications the patient is taking. Similar to the 2006 version, this educational review focuses on neuropsychiatric medications but also covers all other drugs to the extent that they interact with psychiatric medications. It emphasizes the role of pharmacologic principles to guide the safe and effective use of multiple medications when such use is necessary. Consistent with these principles, this review presents tables outlining major pharmacodynamic and pharmacokinetic mechanisms mediating DDIs relevant to the patient on psychiatric medications.

Original languageEnglish (US)
Pages (from-to)45-74
Number of pages30
JournalPrimary Psychiatry
Issue number12
StatePublished - Dec 1 2009

ASJC Scopus subject areas

  • Psychiatry and Mental health

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    Preskorn, S. H., & Flockhart, D. (2009). 2010 guide to psychiatric drug interactions. Primary Psychiatry, 16(12), 45-74.