Hoffelt Charity, Gross Tonya
Inpatient Clinical Pharmacist, Avera Behavioral Health, Sioux Falls, South Dakota,
PGY-2 Psychiatry Resident, Avera Behavioral Health, Sioux Falls, South Dakota.
Ment Health Clin. 2016 Mar 8;6(1):35-41. doi: 10.9740/mhc.2016.01.035. eCollection 2016 Jan.
Treatment of depression often requires long-term management with medication. Practitioners should be aware of potentially significant drug interactions with the use of antidepressants in order to effectively prevent or manage adverse events while optimizing patient response to treatment. Most antidepressants are metabolized by the liver, primarily via the CYP450 system. Pharmacokinetic profiles of the most recently approved antidepressants are reviewed in addition to evidence supporting potentially significant interactions. In addition, pharmacokinetic interactions between multiple antidepressants and other drug classes, including opiates, antineoplastics, antiepileptics, and antipsychotics, are discussed. This article provides recommendations for the monitoring and management of drug interactions. In addition, limitations of the evidence are reviewed.
抑郁症的治疗通常需要长期药物管理。从业者应了解使用抗抑郁药时可能存在的重大药物相互作用，以便在优化患者治疗反应的同时有效预防或管理不良事件。大多数抗抑郁药由肝脏代谢，主要通过细胞色素P450系统。除了支持潜在重大相互作用的证据外，还对最新批准的抗抑郁药的药代动力学特征进行了综述。此外，还讨论了多种抗抑郁药与其他药物类别（包括阿片类药物、抗肿瘤药、抗癫痫药和抗精神病药）之间的药代动力学相互作用。本文提供了药物相互作用监测和管理的建议。此外，还对证据的局限性进行了综述。
