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Clinical Pharmacokinetics

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01.10.2001 | Review Article

Pharmacokinetic and Pharmacodynamic Drug Interactions in the Treatment of Attention-Deficit Hyperactivity Disorder

verfasst von: John S. Markowitz, Dr Kennerly S. Patrick

Erschienen in: Clinical Pharmacokinetics | Ausgabe 10/2001

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Abstract

The psychostimulants methylphenidate, amphetamine and pemoline are among the most common medications used today in child and adolescent psychiatry for the treatment of patients with attention-deficit hyperactivity disorder. Frequently, these medications are used in combination with other medications on a short or long term basis. The present review examines psychostimulant pharmacology, summarises reported drug-drug interactions and explores underlying pharmacokinetic and pharmacodynamic considerations for interactions. A computerised search was undertaken using Medline (1966 to 2000) and Current Contents to provide the literature base for reports of drug-drug interactions involving psycho-stimulants. These leads were further cross-referenced for completeness of the survey.

Methylphenidate appears to be more often implicated in pharmacokinetic interactions suggestive of possible metabolic inhibition, although the mechanisms still remain unclear. Amphetamine was more often involved in apparent pharmaco-dynamic interactions and could potentially be influenced by medications affecting cytochrome P450 (CYP) 2D6. No published reports of drug interactions involving pemoline were found.

The α₂-adrenergic agonists clonidine and guanfacine have been implicated in several interactions. Perhaps best documented is their antagonism by tricyclic antidepressants and phenothiazines. In additional, concurrent β-blocker use, or abrupt discontinuation, can lead to hypertensive response.

Although there are few published well-controlled interaction studies with psycho-stimulants and α₂-adrenergic agonists, it appears that these agents may be safely coadministered. The interactions of monoamine oxidase inhibitors with psycho-stimulants represent one of the few strict contraindications.

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Titel: Pharmacokinetic and Pharmacodynamic Drug Interactions in the Treatment of Attention-Deficit Hyperactivity Disorder
verfasst von: John S. Markowitz
Dr Kennerly S. Patrick
Publikationsdatum: 01.10.2001
Verlag: Springer International Publishing
Erschienen in: Clinical Pharmacokinetics / Ausgabe 10/2001
Print ISSN: 0312-5963
Elektronische ISSN: 1179-1926
DOI: https://doi.org/10.2165/00003088-200140100-00004

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

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Pharmacokinetic and Pharmacodynamic Drug Interactions in the Treatment of Attention-Deficit Hyperactivity Disorder

Abstract

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

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