Drug toxicity of psychotropic drugs

Drug toxicity of psychotropic drugs.

Drug toxicity is the development of severe, drug-related complications, which may require premature drug withdrawal or dose reduction.

1.acute toxicity is  highest in.                  antidepressants 

lower in neuroleptics 

 very low in anxiolytics.

2.major problems stem 

Anxiolytic ---misuse and overuse. neuroleptics--- tardive dyskinesia is a serious threat to longterm therapy.

 antidepressants---low therapeutic index and a resulting high incidence of severe and fatal poisoning cases, both intentional and accidental.

3.Poisoning death rates per million prescriptions were about 10 times higher for tricyclic antidepressants (TCAs) than for selective serotonin reuptake inhibitors (SSRIs), England and Wales, 1993-2004

4.Psychotropic drugs with hepatotoxic potential can be classified based on their intended use: 

1) antipsychoticsneuroleptics including phenothiazines, butyrophenones, and clozapine

 2) antidepressants including tricyclics, serotonin reuptake inhibitors, and monoamine oxidase (MAO) inhibitors; 

3) anti-anxiety drugs such as benzodiazepines; 

4) acetylcholinesterase inhibitors such as tacrine; and 

5) drugs of abuse including cocaine and ecstasy. 

5 Bipolar and other psychiatric disorders are associated with considerably increased risk of suicidal behaviour, which may include self-poisoning with medication used to treat the disorder. Therefore, choice of medication for treatment should include consideration of toxicity, especially for patients at risk. 

6.effects on geriatric patients

examples of drug-drug toxicity are discussed:(a) interaction between psychotropic drugs and guanethidine (Ismelin); and (b) combinations of phenothiazines, antiparkinsonian drugs, and tricyclic antidepressants.

Ref :

1.Use of psychotropic drugs in geriatric patients.John M DavisJournal of geriatric psychiatry, 1974

2.Acute and chronic toxicity of psychotropic drugs]. Bickel MH. Schweiz Arch Neurol Psychiatr (1985). 1986.