Drug interactions in gerontopsychiatry – the choice of antipsychotics and antidepressants for geriatric patients

Česká verzia

Authors: Jana Michalcová ^1,2; Ivana Tašková ^1,2; Katarína Bielaková ^3,4
Authors place of work: Ústav aplikované farmacie, Farmaceutická fakulta MU Brno ¹; Pracoviště klinické farmacie, Psychiatrická nemocnice Bohnice, Praha ²; Klinika interní, geriatrie a praktického lékařství LF MU a FN Brno ³; Ústav farmakologie LF MU a FN Brno ⁴
Published in the journal: Geriatrie a Gerontologie 2022, 11, č. 2: 61-67
Category: Přehledový článek

Summary

When different drugs are combined, drug interactions may lead to increased or decreased effect of the pharmacotherapy. Each drug may interact with another drug, dietary supplement, or food ingredient. Drugs overlap in their receptor profile via pharmacodynamic interaction, or target drug concentrations may be affected via pharmacokinetic interaction. Increased concentrations of the drug manifest in adverse drug reactions, whereas decreased concentrations of the drug in plasma result in ineffective treatment. In both cases, drug interaction is a very undesirable phenomenon we try to prevent, because it causes prolonged hospitalization, worsens quality of life of geriatric patients and increases health care costs. Prevention and elimination of drug interactions are objectives of safe pharmacotherapy. This article describes basic drug interactions in gerontopsychiatry, focusing specifically on antipsychotics and antidepressants. The article provides information about substrates, inhibitors and inducers of cytochrome P450. Furthermore, it presents the need for multidisciplinary cooperation of the physician and clinical pharmacist to solve drug interactions. In addition, examples of drug interactions are demonstrated using case reports from clinical practice, as experienced by geriatric patients.

Keywords:

antidepressants – geriatric patient – Antipsychotics – Drug interactions – psychiatry

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