title: Toxicological interactions involving psychiatric drugs and alcohol: an update.
abstract: This review focuses on the toxicological interactions between alcohol (ethanol) and psychiatric drugs (antidepressants and antipsychotics), including those leading to fatal poisoning. Acute or chronic ingestion of alcohol when combined with psychiatric drugs may lead to several clinically significant toxicological interactions. The metabolism of these drugs is generally but not always delayed by acute alcohol ingestion. Drugs undergoing metabolism may also show increased metabolic clearance with chronic alcohol ingestion. Therefore, the net effect may be influenced by internal (e.g. disease, age, gender), external (e.g. environment, diet) and pharmacokinetic (e.g. dose, timing of ingestion, gastrointestinal absorption, distribution and elimination) factors. Cases of fatal poisoning involving coadministration of psychiatric drugs, alcohol and other drugs prompted this review.
authors.affiliation: Department of Forensic Medicine, Institute of Community Medicine, University of Tsukuba, Ibaraki-ken, Japan. einosuke@md.tsukuba.ac.jp
authors.forename: E
authors.initials: E
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000378:metabolism / Q000493:pharmacokinetics; D019540:Area Under Curve; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism / Q000502:physiology; D004347:Drug Interactions; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D006207:Half-Life; D006801:Humans; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D011041:Poisoning / Q000201:enzymology / Q000378:metabolism / Q000401:mortality
chemical_list: D014150:Antipsychotic Agents; D000431:Ethanol; D003577:Cytochrome P-450 Enzyme System