CLINICALLY RELEVANT DRUG INTERACTIONS IN THE TREATMENT OF SECOND-GENERATION ANTIPSYCHOTICS

Abstract

The article provides a review of the literature on the problem of drug interactions among modern antipsychotics. Clinically significant pharmacokinetic and pharmacodynamic interactions of second5generation antipsychotics with psychotropic and somatotropic agents during combined pharmacotherapy are described. The mechanisms underlying the occurrence of drug interactions are disclosed. It has been shown that most often drug interactions occur at the metabolic level with the participation of isoenzymes CYP1A2, CYP2D6 and CYP3A4. Potent inhibitors of CYP3A4 (fluvoxamine and fluoxetine) and CYP2D6 (fluoxetine and paroxetine) can slow down the metabolism of antipsychotics and lead to the development of side effects. Particular attention is paid to the problem of pharmacodynamic interactions associated with prolongation of the QT interval. A list of somatotropic drugs is presented, the appointment of which should be avoided in conjunction with second5 generation antipsychotics in order to prevent the development of cardiac arrhythmias.