Muscatello Maria Rosaria, Spina Edoardo, Bandelow Borwin, Baldwin David S
Section of Psychiatry, Department of Neurosciences, Psychiatric and Anaesthesiological Sciences, University of Messina, Messina, Italy.
Hum Psychopharmacol. 2012 May;27(3):239-53. doi: 10.1002/hup.2217. Epub 2012 Feb 7.
Certain drugs used in the treatment of patients with anxiety disorders can interact with other psychotropic drugs and with pharmacological treatments for physical illnesses. There is a need for an updated comparative review of clinically relevant drug interactions in this area.
Relevant literature on drug interactions with medications used in the treatment of anxiety disorders was identified through a search in MEDLINE and EMBASE.
Drug interactions involving medications used to treat anxiety disorders may be pharmacokinetic, such as enzyme inhibition or induction in the cytochrome P450 system and transporter-mediated drug interactions, or pharmacodynamic, such as additive effects in causing drowsiness or additive effects at neurotransmitter receptors. Certain selective serotonin reuptake inhibitors (fluoxetine, fluvoxamine, and paroxetine) are particularly liable to be potentially involved in untoward pharmacokinetic interactions.
The potential for drug interactions with medications used in anxiety disorders should be the cause of clinical concern, particularly in elderly individuals. However, the liability for harmful drug interactions may be anticipated, and the risk reduced. Although not all interactions are clinically relevant, careful monitoring of clinical response and possible interactions is essential.
用于治疗焦虑症患者的某些药物可与其他精神药物以及治疗躯体疾病的药物发生相互作用。有必要对该领域临床相关药物相互作用进行更新的比较性综述。
通过检索MEDLINE和EMBASE确定了与用于治疗焦虑症的药物发生相互作用的相关文献。
涉及用于治疗焦虑症药物的药物相互作用可能是药代动力学方面的，如细胞色素P450系统中的酶抑制或诱导以及转运体介导的药物相互作用，或者是药效学方面的，如导致嗜睡的相加作用或神经递质受体处的相加作用。某些选择性5-羟色胺再摄取抑制剂（氟西汀、氟伏沙明和帕罗西汀）特别容易潜在地参与不良药代动力学相互作用。
与用于治疗焦虑症的药物发生相互作用的可能性应引起临床关注，尤其是在老年人中。然而，可以预测有害药物相互作用的可能性并降低风险。虽然并非所有相互作用都具有临床相关性，但仔细监测临床反应和可能的相互作用至关重要。
