University of Kentucky Mental Health Research Center at Eastern State Hospital, 1350 Bull Lea Road, Lexington, KY, 40511, USA.
Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain.
Curr Psychiatry Rep. 2018 Mar 12;20(3):17. doi: 10.1007/s11920-018-0881-3.
Patients with bipolar disorder are frequently treated with polypharmacy. This article should provide clinicians with an understanding of how polypharmacy can contribute to pharmacokinetic and pharmacodynamic drug-drug interactions (DDIs).
The pharmacokinetics and pharmacodynamics of lithium and other mood stabilizers (valproate, lamotrigine, carbamazepine, oxcarbazepine, and eslicarbazepine), antipsychotics, and selective serotonin reuptake inhibitors (SSRIs) were reviewed and summarized in the first four tables describing their pharmacokinetic and pharmacodynamic mechanisms. Four tables summarized the DDIs which are likely to be clinically relevant in adults with bipolar disorder: two for mania treatments (with and without carbamazepine), one for maintenance treatments, and one for depression treatments. The purpose is to be practical, helping clinicians pay attention to and manage polypharmacy, avoiding adverse drug reactions (ADRs) in patients with bipolar disorder, including both the frequent ADRs and those rare but potentially lethal ADRs. Future articles should improve these tables.
双相情感障碍患者常采用多种药物治疗。本文旨在帮助临床医生了解多药治疗如何导致药代动力学和药效学药物-药物相互作用（DDI）。
锂和其他心境稳定剂（丙戊酸盐、拉莫三嗪、卡马西平、奥卡西平、和依沙佐米）、抗精神病药和选择性 5-羟色胺再摄取抑制剂（SSRIs）的药代动力学和药效学在前面的四个表格中进行了综述和总结，描述了它们的药代动力学和药效学机制。四个表格总结了在双相情感障碍成人中可能具有临床相关性的 DDI：两个表格用于治疗躁狂（有和无卡马西平），一个用于维持治疗，一个用于治疗抑郁。目的是实用，帮助临床医生关注和管理多药治疗，避免双相情感障碍患者的药物不良反应（ADR），包括常见的 ADR 和那些罕见但潜在致命的 ADR。未来的文章应改进这些表格。
