Pharmacokinetic drug interactions and adverse consequences between psychotropic medications and pharmacotherapy for the treatment of opioid dependence

Saber-Tehrani, Ali; Bruce, R. Douglas; Altice, Frederick L.

doi:10.3109/00952990.2010.540279

Cited by 33 publications

(37 citation statements)

References 118 publications

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“…Fluoxetine and paroxetine are antidepressants that are regularly prescribed to children with depression. Animal and human research has shown that these can reduce the rate of metabolism of BZD, 34 and in one recent animal study the combination of fluoxetine and BZD actually reversed fluoxetine's anxiogenic effects. 35 These findings, and the observation that a significant proportion of children on BZD are also being prescribed antidepressants, suggest that an examination of the interactive effects of BZD and other psychotropic drugs are an important area of further investigation in paediatric prescribing.…”

Section: Concomitant Medicationsmentioning

confidence: 99%

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Benzodiazepine prescribing in children under 15 years of age receiving free medical care on the General Medical Services scheme in Ireland

et al. 2015

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ObjectiveTo examine the prevalence and secular trends in benzodiazepine (BZD) prescribing in the Irish paediatric population. In addition, we examine coprescribing of antiepileptic, antipsychotic, antidepressant and psychostimulants in children receiving BZD drugs and compare BZD prescribing in Ireland to that in other European countries.SettingData were obtained from the Irish General Medical Services (GMS) scheme pharmacy claims database from the Health Service Executive (HSE)—Primary Care Reimbursement Services (PCRS).ParticipantsChildren aged 0–15 years, on the HSE-PCRS database between January 2002 and December 2011, were included.Primary and secondary outcome measuresPrescribing rates were reported over time (2002–2011) and duration (≤ or >90 days). Age (0–4, 5–11, 12–15) and gender trends were established. Rates of concomitant prescriptions for antiepileptic, antipsychotics, antidepressants and psychostimulants were reported. European prescribing data were retrieved from the literature.ResultsRates decreased from 2002 (8.56/1000 GMS population: 95% CI 8.20 to 8.92) to 2011 (5.33/1000 GMS population: 95% CI 5.10 to 5.55). Of those children currently receiving a BZD prescription, 6% were prescribed BZD for >90 days. Rates were higher for boys in the 0–4 and 5–11 age ranges, whereas for girls they were higher in the 12–15 age groups. A substantial proportion of children receiving BZD drugs are also prescribed antiepileptic (27%), antidepressant (11%), antipsychotic (5%) and psychostimulant (2%) medicines. Prescribing rates follow a similar pattern to that in other European countries.ConclusionsWhile BZD prescribing trends have decreased in recent years, this study shows that a significant proportion of the GMS children population are being prescribed BZD in the long term. This study highlights the need for guidelines for BZD prescribing in children in terms of clinical indication and responsibility, coprescribing, dosage and duration of treatment.

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Section: Concomitant Medicationsmentioning

confidence: 99%

“…A study in Japan found that 60% of patients who presented with major depression were prescribed a combination of BZD and antidepressants on their first psychiatric visit. 34 In spite of high rates of coprescribing, the efficacy of combined antidepressants and BZD in the treatment of psychiatric symptoms has not been established.…”

Section: Concomitant Medicationsmentioning

confidence: 99%

Benzodiazepine prescribing in children under 15 years of age receiving free medical care on the General Medical Services scheme in Ireland

et al. 2015

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“…Dangers include altered metabolism of either medication, methadone overdose, and opioid withdrawal syndromes. Awareness of these interactions is critical (37).…”

Section: Pharmacological Optionsmentioning

confidence: 99%

Prescription Pain Medication Dependence

Dodrill¹,

Helmer²,

Kosten³

2011

AJP

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“…Second, these studies focus on single drug-drug interactions; however, the patient is frequently taking several medications that have not been studied when ingested simultaneously. This is particularly an issue for patients on methadone/buprenorphine given the high prevalence of psychiatric co-morbidity and possible interactions between psychotropic medications and methadone/buprenorphine [14,198]. Third, these studies typically exclude patients with many of the common abnormalities that HIV/HCV patients experience such as hepatic and renal impairments.…”

Section: Clinical Management Of Opioid Withdrawal or Excessmentioning

confidence: 99%

A review of pharmacological interactions between HIV or hepatitis C virus medications and opioid agonist therapy: implications and management for clinical practice

Bruce

Moody

Altice

et al. 2013

Expert Review of Clinical Pharmacology

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Global access to opioid agonist therapy and HIV/HCV treatment is expanding but when used concurrently, problematic pharmacokinetic and pharmacodynamic interactions may occur. Review of articles from 1966 into 2012 in Medline using the following keywords: HIV, AIDS, HIV therapy, HCV, HCV therapy, antiretroviral therapy, HAART, drug interactions, methadone, and buprenorphine. Additionally, abstracts from national and international meetings and a review of conference proceedings were conducted; selected reports were reviewed as well. The metabolism of both opioid and antiretroviral therapies, description of their known interactions, and clinical implications and management of these interactions are reviewed. Important pharmacokinetic and pharmacodynamic drug interactions affecting either methadone or HIV medications have been demonstrated within each class of antiretroviral agents. Drug interactions between methadone, buprenorphine and HIV medications are known and may have important clinical consequences. Clinicians must be alert to these interactions and have a basic knowledge regarding their management.

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Pharmacokinetic drug interactions and adverse consequences between psychotropic medications and pharmacotherapy for the treatment of opioid dependence

Abstract: Several interactions between methadone, buprenorphine, or naltrexone and psychoactive medications are described and may have important clinical consequences. To optimize care, clinicians must be alerted to these interactions.

Cited by 33 publications

References 118 publications

Benzodiazepine prescribing in children under 15 years of age receiving free medical care on the General Medical Services scheme in Ireland

Benzodiazepine prescribing in children under 15 years of age receiving free medical care on the General Medical Services scheme in Ireland

Prescription Pain Medication Dependence

A review of pharmacological interactions between HIV or hepatitis C virus medications and opioid agonist therapy: implications and management for clinical practice

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