Adverse Drug Reactions, Intoxications and Interactions of Neuropsychotropic Medications

Abstract

Any medication has desirable effects (e.g., alleviation of depressive symptoms) and may produce undesirable, unintended effects (e.g., headache or vomiting) which are called 'adverse reactions' or 'adverse drug reactions' (ADRs). ADRs can be 'severe' / 'serious' and have to be differentiated from 'side effects' and 'adverse events.' Definitions for these terms are given in this chapter. Many ADRs can be explained by the pharmacologic target(s) of the prescribed medication. This chapter gives a comprehensive review of these molecular targetbased ADRs. To emphasize, some ADRs cannot be explained yet in sufficient detail by the pharmacologic target profile of the prescribed drug. Fortunately, we live in a great era with respect to wealth of and ease of access to information (i.e., the Internet). As no single individual can hold all the ADR information currently available and as it is not advisable to rely on a single database only, this chapter also contains a comprehensive description of available databases on ADRs, pharmacogenetic profiles of drug metabolism, drug interactionsincluding pharmacogenetic onesand toxicologic information on medications. UK United Kingdom VMAT2 Vesicular monoamine transporter, subtype 2 VSCC Calcium channel, voltage sensitive VSSC Sodium channel, voltage sensitive

Behind the Curtain: Therapeutic Drug Monitoring of Psychotropic Drugs from a Laboratory Analytical Perspective

“…23 Detailed introduction to enantiomer nomenclature is available elsewhere. 23,24 Isomers may differ in terms of their pharmacodynamic, pharmacokinetic, and toxicological properties. 25 However, most chiral psychotropic drugs have been introduced as racemates for therapeutic purposes.…”

“…The therapeutic superiority of these eutomers with respect to safety and efficacy has been described in detail previously. 24 Of note, when a pure enantiomer is administered, racemate can be formed in the body via chiral conversion. 25 However, stereoselective assays of the enantiomers of racemic drugs are rarely available for routine clinical use.…”