ArticleBritish journal of clinical pharmacology2004
Potential for drug interactions involving cytochromes P450 2D6 and 3A4 on general adult psychiatric and functional elderly psychiatric wards.
Article in British journal of clinical pharmacology, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.
- Prevalence and solving strategies of drug-related problems in adult psychiatric inpatients - a systematic review.Frontiers in psychiatry · 2024Pooled it
- Delirium secondary to anticholinergics.BMJ case reports · 2023Article
- Impact of theFrontiers in pharmacology · 2022Article
- Prevalence and sort of pharmacokinetic drug-drug interactions in hospitalized psychiatric patients.Journal of neural transmission (Vienna, Austria : 1996) · 2020Article
- Cytochrome P450 (CYP450) Interactions Involving Atypical Antipsychotics are Common in Community-Dwelling Older Adults Treated for Behavioral and Psychological Symptoms of Dementia.Pharmacy (Basel, Switzerland) · 2020Article
- City-wide electronic health records reveal gender and age biases in administration of known drug-drug interactions.NPJ digital medicine · 2019Article
- Discontinuation and dose adjustment of metoprolol after metoprolol-paroxetine/fluoxetine co-prescription in Dutch elderly.Pharmacoepidemiology and drug safety · 2018Article
- Sequential drug treatment algorithm for agitation and aggression in Alzheimer's and mixed dementia.Journal of psychopharmacology (Oxford, England) · 2018Article
- Frequency and clinical relevance of potential cytochrome P450 drug interactions in a psychiatric patient population - an analysis based on German insurance claims data.BMC health services research · 2016Article
- Evaluation of Potential Drug-Drug Interactions with Antidepressants in Two Tertiary Care Hospitals.Journal of clinical and diagnostic research : JCDR · 2015Article
- Understanding and preventing drug-drug and drug-gene interactions.Expert review of clinical pharmacology · 2014Review
- Extent of poly-pharmacy, occurrence and associated factors of drug-drug interaction and potential adverse drug reactions in Gondar Teaching Referral Hospital, North West Ethiopia.Journal of advanced pharmaceutical technology & research · 2013Article
- Prevalence of drug interactions in hospital healthcare.International journal of clinical pharmacy · 2012Review
- Dose-response relationship between selective serotonin re-uptake inhibitors and injurious falls: a study in nursing home residents with dementia.British journal of clinical pharmacology · 2012Article
- Modeling chemical interaction profiles: I. Spectral data-activity relationship and structure-activity relationship models for inhibitors and non-inhibitors of cytochrome P450 CYP3A4 and CYP2D6 isozymes.Molecules (Basel, Switzerland) · 2012Article
- Modeling chemical interaction profiles: II. Molecular docking, spectral data-activity relationship, and structure-activity relationship models for potent and weak inhibitors of cytochrome P450 CYP3A4 isozyme.Molecules (Basel, Switzerland) · 2012Article
- Pharmacogenetic testing and therapeutic drug monitoring are complementary tools for optimal individualization of drug therapy.European journal of clinical pharmacology · 2010Review
- Nationwide drug-dispensing data reveal important differences in adherence to drug label recommendations on CYP2D6-dependent drug interactions.British journal of clinical pharmacology · 2010Article
- Potential for drug interactions involving cytochrome P450 in patients attending palliative day care centres: a multicentre audit.British journal of clinical pharmacology · 2005Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo assess the potential for interactions involving cytochromes P450 2D6 (CYP2D6) and 3A4 (CYP3A4) between drugs prescribed in a city in-patient psychiatric service.
methodsPrescription information was obtained from all 236 patients in general adult wards and all 87 patients in functional elderly wards under a city psychiatric service. The frequencies with which combinations of drugs expected to interact via CYP2D6 or CYP3A4 were documented and compared between these two settings.
resultsAll 2089 drug prescriptions, of which 1237 (59%) were administered, were analyzed. One hundred and seventy-two patients (73%) on adult wards and 59 (68%) on functional elderly wards were prescribed at least one drug metabolized by and/or inhibiting CYP2D6, the difference being nonsignificant (95% confidence interval on the difference -6.3%, 16.4%). Anticipated interactions from 62/82 CYP2D6-related combinations prescribed on adult wards (27/100 patients) and 19/30 prescribed to elderly patients (22/100 patients) were judged to be clinically important or potentially clinically important. The proportion of patients on functional elderly wards prescribed at least one drug interacting with CYP3A4 (87%) was significantly greater than that for patients on adult wards (57%, P < 0.001). The frequency of interactions involving CYP3A4 was significantly greater on functional elderly than adult wards (43/100 vs 22/100 patients, P < 0.025, 95% confidence interval on the difference 4, 38/100).
conclusionsOur findings confirm extensive polypharmacy on general adult psychiatric and functional elderly psychiatric wards. A substantial proportion of patients were receiving combinations of drugs that interact with CYP2D6 and/or CYP3A4, many of which are known to produce clinically important interactions. Doctors practising in old age psychiatry should be aware that patients on functional elderly wards are at increased risk of clinically important CYP3A4 interactions. Psychiatrists should consider the pharmacokinetic implications of drugs prescribed for use 'as needed', because of the potential for unpredictable interactions.
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