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Possible Pharmacodynamic and Pharmacokinetic Drug-Drug Interactions That Are Likely to Be Clinically Relevant and/or Frequent in Bipolar Disorder

  • Mood Disorders (E Baca-Garcia, Section Editor)
  • Published:
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Abstract

Purpose of Review

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).

Recent Findings

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.

Summary

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.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Acknowledgements

The authors acknowledge Lorraine Maw, M.A., at the University of Kentucky Mental Health Research Center at Eastern State Hospital, Lexington, KY, USA, who helped in editing this article.

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Authors and Affiliations

  1. University of Kentucky Mental Health Research Center at Eastern State Hospital, 1350 Bull Lea Road, Lexington, KY, 40511, USA

    Jose de Leon

  2. Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain

    Jose de Leon

  3. Biomedical Research Centre in Mental Health Net (CIBERSAM), Santiago Apóstol Hospital, University of the Basque Country, Vitoria, Spain

    Jose de Leon

  4. Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy

    Edoardo Spina

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Correspondence to Jose de Leon.

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This article is part of the Topical Collection on Mood Disorders

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de Leon, J., Spina, E. Possible Pharmacodynamic and Pharmacokinetic Drug-Drug Interactions That Are Likely to Be Clinically Relevant and/or Frequent in Bipolar Disorder. Curr Psychiatry Rep 20, 17 (2018). https://doi.org/10.1007/s11920-018-0881-3

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