scholarly journals Psychotropic Drugs: Implications For Dental Practice

2008 ◽  
Vol 55 (3) ◽  
pp. 89-99 ◽  
Author(s):  
Daniel E. Becker
Keyword(s):  
Anxiety Disorder ◽  
Side Effects ◽  
Drug Interactions ◽  
Dental Care ◽  
Psychotropic Drugs ◽  
Preoperative Assessment ◽  
Psychotropic Medications ◽  
Dental Practice ◽  
Dental Patients ◽  
Psychiatric Illnesses

Abstract Appropriate preoperative assessment of dental patients should always include analysis of their medications. Psychiatric illnesses including panic/anxiety disorder, depression, psychoses, and manic disorders are prevalent within our society. An impressive number of drug formulations are prescribed for these disorders, and they introduce concern regarding side effects and possible drug interactions with medications the dentist may deem necessary for dental care. This article will address essential pharmacology of these psychotropic medications.

Frequency and Predictors of Potential Drug Interactions among Psychiatry Outpatients on Treatment with Antidepressant Medications

2021 ◽  
Vol 14 (3) ◽  
pp. 1209-1218
Author(s):  
Mouza S.R Al Zaabi ◽  
Sathvik Belagodu Sridhar ◽  
Talaat Matar Tadross ◽  
Atiqulla Shariff
Keyword(s):  
Drug Interactions ◽  
Outpatient Setting ◽  
Psychotropic Medications ◽  
Potential Drug ◽  
Cross Sectional ◽  
Antidepressant Medications ◽  
Psychiatric Illnesses ◽  
Risk Patients ◽  
Social Habits ◽  
Clinical Conditions

Antidepressant medications are prescribed to treat depression and related psychiatric illnesses. In patients with depression, many categories of drugs are prescribed to treat clinical conditions and comorbidities. Hence, it is essential to screen such patients for potential drug interactions. The study aimed to assess the frequency of potential drug interactions (pDDIs) associated with antidepressant medications administered to the outpatients of the psychiatry department. This cross-sectional investigation was conducted in a psychiatry outpatient setting. Patients satisfying inclusion criteria were screened for pDDIs by reviewing the patients’ electronic case records. All the identified pDDIs were further evaluated using Micromedex database 2.0.A total of 131 eligible patients’ case records were reviewed. The frequency of pDDIs between antidepressants and other psychotropic medications, antidepressants and non-psychotropic medications, antidepressants,tobacco, antidepressants, and ethanol was 48.1%,9.2%, 7.6%, and 3.8%, respectively. Use of more than three medications [RR: 1.5; CI: 1.1-2.1], presence of total [RR: 7.9; CI: 1.1-52.5] as well as psychiatric polypharmacy [RR: 4.8; CI: 1.3-17.9] were identified as predisposing factors of pDDIs.The results of the multiple regression indicated that the model was a significant predictor of pDDIs (F[3, 127]= 6.368, p<0.01, R2 = 0.13). In comparison,psychiatric polypharmacy was the only variable contributing significantly to the model (B = -0.423, p<.05). Nearly fifty percent of patients taking antidepressant medications were found to have the potential for developing drug interactions. Review of treatment charts for psychotropic, non-psychotropic, and non-prescription medications, along with different medical conditions that patients suffer from and the social habits of patients,is essential to identify and resolve potential drug interactions in at-risk patients.

Outpatient Psychotropic Drug Interactions in a Public Psychiatry Hospital in Bahrain: An Audit Study

2021 ◽  
Vol 10 ◽  
Author(s):  
Yasin Tayem ◽  
Saeed Aljaberi ◽  
Ali Alfehaid ◽  
Abdulaziz Almekhyal ◽  
Haitham Jahrami ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Psychotropic Drugs ◽  
Psychiatric Patients ◽  
Psychotropic Medications ◽  
Outpatient Psychiatry ◽  
High Prevalence ◽  
Public Psychiatry ◽  
And Gender ◽  
Potential Interactions ◽  
Outpatient Prescriptions

Background: Psychotropic polypharmacy is particularly common which puts psychiatric patients at high risk for developing drug-drug interactions. Objective: We aimed to study potential interactions between psychotropic medications prescribed within the outpatient psychiatry setting. Method: This was an audit study, which targeted a sample of outpatient prescriptions ordered within the outpatient clinics of the main psychiatry hospital in Bahrain over 2017. We studied the degree and correlation between psychotropic drugs. Results: The total number of prescriptions in our sample was 992 (56.1% males, 43.9% females). Psychotropic polypharmacy was detected in 842 prescriptions (84.9%). Potential interactions between psychotropic drugs were observed in 550 prescriptions (56.4%). The degree of interaction was minor in 43 prescriptions (7.8%), significant in 419 prescriptions (76.2%), and serious in 88 prescriptions (16%). Schizoaffective disorder subjects were the most likely to suffer from interactions (64.6%), whereas prescriptions issued for those who had schizophrenia contained the least number of interactions (51.6%). The total number of interactions was strongly associated with polypharmacy (p < .001), and gender (p < .01), but not with age (p > .05) or diagnosis (p > .05). Conclusion: High prevalence of polypharmacy and interactions between psychotropic medications were observed in our sample, particularly of the significant grade.

Monoamine Agonists (“Antidepressants”), Including Dopamine Agonists (“Stimulants”)

2018 ◽  
pp. 85-100
Author(s):  
S. Nassir Ghaemi
Keyword(s):  
Clinical Pharmacology ◽  
Side Effects ◽  
Sexual Dysfunction ◽  
Drug Interactions ◽  
Psychotropic Drugs ◽  
Withdrawal Syndrome ◽  
Serotonin Reuptake ◽  
Dopamine Agonists ◽  
Serotonin Reuptake Inhibitors ◽  
Norepinephrine Reuptake

The drug class of monoamine agonists includes agents called antidepressants and stimulants. Monoamine agonists are the most widely used class of psychotropic drugs. There are three major monoamines, and thus three main types of monoamine agonists. We consider each in turn: the serotonin reuptake inhibitors (SRIs), norepinephrine reuptake inhibitors (NRIs), and dopaminergic agents. We also discuss the dopamine agonists—bupropion (Wellbutrin) and amphetamines (“stimulants”), as well as other new monoamine agonists. The clinical pharmacology of specific agents within each class, including their efficacy and side effects, is explored. Specific phenomena surveyed include SRI tolerance, sexual dysfunction, drug interactions, serotonin withdrawal syndrome, and suicide and akathisia.

scholarly journals EFFECT OF PAROXETINE IN ANXIETY DISORDER AMONG SCHOOL DROPOUT TEENAGER IN SOUTH INDIAN POPULATION

2020 ◽  
pp. 23-25
Author(s):  
PADMA PRIYA CHANDRAN ◽  
SINDHU S. ◽  
NAVANEETHAKRISHNAN S. ◽  
SASIKUMAR S. ◽  
KARTHIK S.
Keyword(s):  
Anxiety Disorder ◽  
Side Effects ◽  
Rating Scale ◽  
Psychiatric Ward ◽  
South Indian Population ◽  
Psychiatric Illnesses ◽  
South Indian ◽  
Common Group ◽  
Hamilton Anxiety Rating Scale ◽  
Hamilton Anxiety

Objective: Anxiety disorders are the most common group of psychiatric illnesses in children. This study is to observe the effectiveness of Paroxetine in anxiety disorder among teenagers in South India population using Hamilton Anxiety Rating Scale (HAM-A) and to screen the possible risk for paroxetine in anxiety disorder among teenagers. Methods: This study is a prospective observational study that was conducted for a period of 6 mo. Of 84 teenage patients with anxiety disorder assessed using Hamilton Anxiety Rating Scale (HAM-A) were followed-up in an outpatient psychiatric ward. Study population includes both sexes, age group between 13 to 19 y, Teenage patient receiving paroxetine for anxiety disorder were included and patients unwilling to give written informed consent or assent form were excluded. Results: Out of 84 patients the prevalence of symptoms before the drug treatment, 65 patients were falling in very severe category, which was assessed by HAM-A scale. Then reassessed with drug Paroxetine at week 4 and week 8. There was a drastic reduction in the prevalence of symptoms in week 8 than compared to week 4. A significant reduction in body weight was also observed during the study period. Among various side effects, nausea was the prominent risk found during the study. Conclusion: The present study demonstrated that paroxetine is effective and well-tolerated for the treatment of various types of anxiety disorder in teenagers with few side effects.

Placebos in Clinical Trials of Psychotropic Medication

1997 ◽  
Vol 42 (3) ◽  
pp. 1-6 ◽  
Author(s):  
Donald Addington ◽  
Richard Williams ◽  
Yvon Lapierre ◽  
Nady El-Guebaly
Keyword(s):  
Clinical Trials ◽  
Side Effects ◽  
High Risk ◽  
Psychotropic Medication ◽  
Psychotropic Drugs ◽  
Placebo Response ◽  
Response Rates ◽  
Psychotropic Medications ◽  
Placebo Controls

This paper represents the position of the Canadian Psychiatric Association on the ethical and scientific issues related to the use of placebos in the evaluation of new psychotropic drugs. The position taken by the Association is that new psychotropic medications must be shown to be effective and must be weighed against the best current interventions. Placebo controls may be appropriate under certain circumstances, even when an established intervention is effective. These include situations in which placebo response rates are high, variable, or close to response rates for effective therapies. Placebo controls arc also appropriate when established interventions cany a high risk of side effects or are effective against only certain symptoms of the disorder.

Pharmacological Issues in Cancer Patients

2017 ◽  
Vol 41 (S1) ◽  
pp. S251-S251
Author(s):  
M. Alves ◽  
A. Tavares
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Drug Interactions ◽  
Cancer Patients ◽  
Psychotropic Drugs ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Mood Stabilizers ◽  
Psychiatric Disease ◽  
Competing Interest

IntroductionDepression and anxiety are the main causes of psychiatric disorder in cancer patients, associated with a decreased tolerance and adherence to cancer treatment, longer hospital stays, decreased quality of life and possibly influence prognosis and mortality.ObjectivesThis review will address psychopharmacological options in cancer patients, side effects and possible drug interactions between psychotropic drugs and chemotherapy, either by toxicity, to which these patients are more sensitive, or a reduction in efficacy in anti-tumor treatment.MethodsNon systematic literature review through the Medline and clinical key databases, with time constraints.ResultsSelective Serotonin Reuptake Inhibitors are the first line treatment for depression, because of their tolerability and safety profile. Venlafaxine is the safer choice for the treatment of depression and hot flushes in women with breast cancer undergoing chemotherapy with tamoxifen. Tricyclic antidepressants are used in patients with neuropathic pain, due to its analgesic properties. Haloperidol is the safest antipsychotic, with less drug interactions and lower metabolic risk. Benzodiazepines are used in anxiety states for short periods. Psychostimulants are an option in patients with depression and life expectancy of less than one month. Mood stabilizers are recommended to treat mania, commonly induced by corticosteroids.ConclusionsTreatment of psychiatric disease in cancer patients leads to an increased adherence to anti-tumoral treatment and improves quality of life. Regardless of the cancer stage there is indication to start treatment. We must, however, take into account possible side effects and drug interactions between psychotropic drugs and chemotherapy, through toxicity or diminished efficacy, when combined with anti-tumoral treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Drug Profile of Adult Patients Attending Five General Dental Practices in Merseyside

2003 ◽  
Vol os10 (4) ◽  
pp. 113-118 ◽  
Author(s):  
Maria J Brindley ◽  
Lesley P Longman ◽  
Christine Randall ◽  
E Anne Field
Keyword(s):  
Dental Care ◽  
Dental Treatment ◽  
Adult Patients ◽  
Dental Practice ◽  
Drug Profile ◽  
Dental Patients ◽  
Oral Side ◽  
General Dental Practitioner ◽  
Systemic Medication ◽  
Dental Practices

Objective To evaluate the drug profile of patients attending general dental practice and to assess the significance of this for the provision of dental care. Design and setting Prospective study of adult patients attending five general dental practices in Merseyside. Materials and methods Patients were questioned about prescribed medication. The data were analysed to assess any potential oral side-effects, pertinent drug interactions, or potential complications of dental treatment. Results A total of 1103 patients were recruited; of these, 287 (26%) were taking systemic medication. Conclusion Approximately a quarter of dental patients attending for routine dental care were taking prescribed medication. The majority of these drugs have significant implications for the general dental practitioner.

Clinical implications and management of drug-drug interactions between antiretroviral agents and psychotropic medications

2013 ◽  
Vol 2 (9) ◽  
pp. 274-285 ◽  
Author(s):  
Meredith G. Jernigan ◽  
Gretchen M. Kipp ◽  
Ashley Rather ◽  
Matthew T. Jenkins ◽  
Allison M. Chung
Keyword(s):  
Human Immunodeficiency Virus ◽  
Drug Interactions ◽  
Psychotropic Medications ◽  
Clinical Implications ◽  
Reverse Transcriptase Inhibitors ◽  
Antiretroviral Agents ◽  
Psychiatric Illnesses ◽  
Antiretroviral Medications ◽  
Immunodeficiency Virus ◽  
Major Drug

Medications used in the treatment of human immunodeficiency virus (HIV) often have drug-drug interactions which complicate treatment of psychiatric illnesses in HIV-infected patients. Protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) are the two classes of HIV medications most likely to be involved with interactions, with the majority occurring via the cytochrome P450 (CYP450) system. These interactions can result in either increased or decreased exposure to psychotropic and antiretroviral medications, often requiring dosage adjustments and increased monitoring. This article reviews some of the major drug interactions with antiretroviral agents.

Anticholinergic Burden among Hospitalised Older Adults with Psychiatric Illnesses- A retrospective study

2020 ◽  
Vol 15 ◽  
Author(s):  
Shiva Shanker Reddy Mukku ◽  
Preeti Sinha ◽  
Palanimuthu Thangaraju Sivakumar ◽  
Mathew Varghese
Keyword(s):  
Older Adults ◽  
Retrospective Study ◽  
Psychiatric Disorders ◽  
Psychotropic Drugs ◽  
Inpatient Care ◽  
Medical Illness ◽  
Anticholinergic Effects ◽  
Psychiatric Illnesses ◽  
Anticholinergic Burden ◽  
Number Of Males

Background: Drugs with anticholinergic properties are known to be associated with deleterious effects on cognition in older adults. There is a paucity of literature in this aspect in older adults with psychiatric disorders. Objective: To examine the anticholinergic cognitive burden and its predictors in hospitalised older adults having psychiatric disorders. Methods: Case records of older adults who sought inpatient care under the Geriatric Psychiatry Unit from January, 2019 to June, 2019 were reviewed. The anticholinergic burden was assessed with Anticholinergic Cognitive Burden (ACB) scale updated version, 2012. Results: Sample included 129 older adults with an almost equal number of males (53.48%) and females (46.52%) having a mean age of 67.84 (SD = 6.96) years. The diagnostic spectrum included depression (34.89%), dementia (31.01%), mania (10.85%), psychosis (13.95%), delirium (6.20%) and others (3.1%). 60.47% of the patients had more than one medical illness. 48.84% of the older adults had clinically relevant anticholinergic cognitive burden ( ACB score ≥ 3). Use of 3 or more psychotropic drugs (OR = 4.88), diagnosis of psychosis/ mania (OR = 7.62) and dementia/ delirium (neurocognitive disorders group) (OR = 5.17) increased the risk of ACB score ≥ 3. Conclusion: Nearly half of the older adults in psychiatry in-patient setting had clinically relevant anticholinergic burden, which was associated with higher use of psychotropics. Our study highlights the importance of monitoring for anticholinergic effects of psychotropics in older adults.

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