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  • Cited by 4
  • Print publication year: 2005
  • Online publication date: September 2009

19 - Antiepileptic drug interactions in patients requiring psychiatric drug treatment

from Part IV - Drug interactions in specific patient populations and special conditions

Summary

In recent years a number of newer antidepressant drugs have been introduced into clinical practice. The new generation of antipsychotic drugs essentially fall into two categories; those that are clozapine related, which included olanzapine and quetiapine, and others such as risperidone. It is also known that many patients with epilepsy receive psychotropic drugs, sometimes but not always on account of psychiatric symptoms. Neuroleptics, such as phenothiazines, are metabolized by intestinal sulfoxidases, although CYP2D6 plays an important role in chlorpromazine and thioridazine metabolism. Antidepressants have been extensively evaluated in relation to the general problem of their proconvulsant activity. Historically, antipsychotic drugs have been considered proconvulsants possibly because of their D2-receptor blocking activity. As far as antidepressant drugs are concerned, fluoxetine and nefazodone interactions are probably the most relevant in epilepsy from a clinical point of view.

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