Pharmaceutical Mind-Altering Substances: Purposes, Classifications, Potential Adverse Effects, and Further Information
Psychotropic drugs, a category of medications used to treat various mental health conditions, play a crucial role in managing disorders such as depression, anxiety, sleep disorders, schizophrenia, bipolar disorder, and ADHD. These medications, however, can interact with other medications, alcohol, over-the-counter (OTC) products, and even certain foods, as we explore in this article.
Medication Interactions
The combination of psychotropic drugs with other medications can have significant effects. For instance, some antidepressants like paroxetine and fluoxetine are strong CYP2D6 inhibitors. When taken with tamoxifen, they can decrease the active metabolite endoxifen, potentially reducing tamoxifen's effectiveness. Other strong inhibitors include bupropion and duloxetine [1].
Combining stimulants, such as amphetamines, with certain antidepressants like Wellbutrin can increase the risk of seizures due to their synergistic effects on the central nervous system [4].
Another dangerous interaction involves Monoamine Oxidase Inhibitors (MAOIs) and foods containing tyramine, like aged cheeses. MAOIs can lead to hypertensive crises when combined with these foods [3].
Alcohol Interactions
Alcohol can enhance the sedative effects of some antidepressants and increase the risk of mental health problems when combined with drugs like Wellbutrin [4]. Combining alcohol with certain OTC medications, such as those containing acetaminophen (e.g., codeine-containing cough syrups), can increase the risk of adverse effects like liver damage [2].
Over-the-Counter (OTC) Product Interactions
Inadvertently combining acetaminophen from different sources (e.g., Tylenol and Percocet) can lead to an overdose, potentially resulting in liver failure [2]. Caffeine, found in some OTC products, can interact with stimulant drugs or psychostimulant medications, enhancing their effects and risk of side effects [4].
Abusing DXM (Dextromethorphan), found in some cough syrups, by combining it with alcohol or other drugs can lead to severe adverse effects [2].
Side Effects and Warning Signs
Side effects of Selective Serotonin Reuptake Inhibitors (SSRIs) may include nausea and vomiting, dizziness, anxiety and agitation, blurred vision, low sex drive, orgasmic dysfunction, and erectile dysfunction. Some adverse effects of SNRIs include headache, nausea and vomiting, high blood pressure, and excessive sweating [1].
Antidepressants are prescribed to treat mental health disorders and include SSRIs, SNRIs, and tricyclic antidepressants. Tricyclic antidepressants can cause side effects such as constipation, dizziness, drowsiness, weight gain, dry mouth, and blurred vision [1].
Antipsychotic medications, such as trifluoperazine, haloperidol, loxapine, thiothixene, molindone, clozapine, risperidone, olanzapine, iloperidone, and paliperidone, treat a variety of conditions, including bipolar disorder and schizophrenia. Some side effects of typical antipsychotics may include a higher risk of stroke, cardiac arrest, and other heart problems, stiffness, shaking, and mobility issues [1].
It's important to note that black box warnings are assigned by the Food and Drug Administration (FDA) to highlight major risks of a medication or its mechanism of action. Psychotropic medications with boxed warnings include antidepressants for the risk of suicidal thoughts and behaviours in children and adolescents, benzodiazepines for the risk of overdose when taken with opioid medications or other central nervous system depressants, stimulants for the risk of dependence and addiction, and antipsychotics for the risk of increased death in older people with dementia-related psychosis [1].
A person should contact a doctor or seek emergency medical attention if they experience adverse effects or think the medication may be causing more harm than help after taking psychotropic medication. It's also crucial to discuss any other medications or supplements a person is taking with their doctor before taking psychotropic medications, as psychotropic drugs interact with other medications, alcohol, over-the-counter products, and foods.
References: [1] National Institute of Mental Health. (2021). Psychotropic Medications. Retrieved from https://www.nimh.nih.gov/health/topics/psychotropic-medications/index.shtml [2] Mayo Clinic. (2021). Drug interactions: How drugs interact. Retrieved from https://www.mayoclinic.org/drugs-supplements/drug-interactions/multimedia/drug-interactions/img-20006389 [3] American Psychiatric Association. (2021). What is Monoamine Oxidase Inhibitors (MAOIs)? Retrieved from https://www.psychiatry.org/patients-families/schizophrenia/treatment/medications/what-are-monoamine-oxidase-inhibitors-maois [4] MedlinePlus. (2021). Drug interactions: Learn about drug interactions. Retrieved from https://medlineplus.gov/druginfo/druginteractions.html
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