Safe and Effective Use of Psychotropic Drugs

This paper outlines the safe and effective use of psychotropic drugs commonly employed in primary care practice. If a patient undergoing primary care develops psychiatric symptoms that necessitate the administration of psychotropic drugs, one needs to be aware of the possibility that the underlying physical disease may have altered the patient’s pharmacokinetics and pharmacodynamics. Changes in pharmacokinetics may cause delays in absorption, distribution, metabolism, and excretion of the drug, leading to high blood concentrations that can result in unexpected adverse reactions. It is also important to consider possible interactions with therapeutic drugs prescribed for the patient’s physical condition. In Japan, recently developed psychotropic drugs, particularly selective serotonin reuptake inhibitors (SSRIs) and selective serotonin and norepinephrine reuptake inhibitors (SNRIs) among the antidepressants and serotonin-dopamine antagonists (SDAs) among the antipsychotic drugs, are associated with greater safety and fewer adverse reactions than conventional psychotropic drugs. Thus, they appear to be appropriate for patients who have both physical and psychiatric disorders and who have visited a primary care clinic.