Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-8300, USA.
Curr Psychiatry Rep. 2012 Aug;14(4):376-90. doi: 10.1007/s11920-012-0284-9.
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.
近年来,在初级保健环境中寻求治疗各种精神疾病的患者数量不断增加,导致开处的精神药物数量增加。随着精神药物的使用增加,初级保健提供者和精神科医生的开处模式存在相当大的差异。由于精神科患者还患有多种其他合并症,因此精神药物的使用增加会使这些患者发生临床显著药物相互作用的风险增加。虽然危及生命的药物相互作用很少见,但已记录到影响药物反应或出现严重药物不良反应的临床显著药物相互作用,并可能影响长期结果。此外,遗传变异对精神药物的药效学和/或药代动力学的影响可能会使药物治疗更加复杂。提高对临床相关精神药物相互作用的认识可以帮助临床医生在初级保健环境中实现患者的最佳治疗效果。