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COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

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<strong>COSIG</strong> Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006<br />

Drug/Medication Interactions<br />

• Alcohol and barbiturates increase<br />

hepatic enzymes; will reduce serum<br />

levels of many psychotropic classes<br />

• Both alcohol and older anti-psychotics<br />

interfere with thermoregulatory centers in<br />

the brain<br />

• Hypertensive crisis can occur from<br />

MAOIs/nutrition combination or from a<br />

combination of older anti-depressants<br />

and psychostimulants<br />

Drug/Medication Interactions (continued)<br />

• Alcohol and cocaine enhance respiratory<br />

depression effects of the opioids &<br />

phenothiazines (e.g. Thorazine)<br />

•Marijuana has anti-cholinergic effects; may<br />

lead to anti-cholinergic psychosis when<br />

combined with anti-cholinergic meds.<br />

•People with schizophrenia are at high risk<br />

of hallucinations from withdrawal from the<br />

CNS depressants<br />

Drug/Medication Interactions (continued)<br />

•Some anti-psychotics (Haldol, Clozaril)<br />

and anti-depressants lower the seizure<br />

threshold; increases risk of seizure from<br />

CNS depressant withdrawal<br />

• Alcohol intoxication and withdrawal<br />

disturbs electrolyte levels which can<br />

lead to lithium toxicity<br />

Summary<br />

•Psychopharmacology is, for the most<br />

part, as much art as it is science. But<br />

current best practice does generally<br />

indicate:<br />

– Atypical antipsychotics over traditional<br />

(typical) antipsychotics<br />

– SSRIs or novel anti-depressants over<br />

TCAs/MAOIs<br />

Summary (cont.)<br />

–Choices do exist when prescribing<br />

anxiolytics; however, benzodiazepines<br />

are sometimes needed<br />

–Prescribed medications are sometimes<br />

psychoactive; psychoactive medications<br />

are sometimes prescribed<br />

Summary (cont.)<br />

The individual is the key;<br />

standards are, at best,<br />

standard.<br />

THANK YOU<br />

8

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