The interaction of antipsycotic and anti-epileptic drugs. case study: Patients epilepsy comorbid psychosis

Innawati Jusup1, IvanaYulia Puspowardojo2, Irena_Aryani 2

1Lecturer, Department Biochemistry and Psychiatry, Medical Faculty, Diponegoro University, Semarang, Indonesia
2Assistant Research, Medical Faculty, Diponegoro University, Indonesia

Background: 39 % Epilepsy comorbid psychiatri disorder, prevalence of psychotic comorbid epilepsy is about 10-19%, found in patients with temporal lobe epilepsy or refractory epilepsy. In epileptic patients with psychotic symptoms, drug interactions between valproic acid and antipsychotics (AP) need to be considered because some APs can have seizure side effects, thus triggering a seizure stimulation threshold in people with epilepsy.

Discussion: Valproic acid as a strong inhibitory broad spectrum enzyme as inhibits the activity of UGTT1A4, UGT2B7, CYP2C9; weakly CYP2C19 and CYP3A4; but does not inhibit CYP1A2, CYP2D6, CYP2A. Interaction valproic acid with AP olanzapine, inductive effect of valproate acid meaning Induced (speed up metabolicd drug) àdrug availability ¯. Haloperidol inhibitor CYP3A4, CYP2D6, UDP glucuronidation, and aripiprazole inhibitor CYP2D6, CYP3A4 meaning inhibition (slow/un metabolic drug)àdrug availability ↑

Conclusion: Interaction valproat choice haloperidol or aripiprazole.

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