What we’ve said about Drug interactions

“Any CYP1A2 substrates, smoking, burning leaf has the potential to induce CYP1A2. So it will decrease the levels of olanzapine and clozapine. Important to consider, patient goes inpatient, isn't smoking, then they go outpatient and all of a sudden the medication is not working as much. Always ask if they're smoking cigarettes”

“CYP1A2 is doing the majority of metabolism. The second one, which is a less significant pathway but still impacts levels, is CYP2D6. So for CYP1A2, the strong inducers, which lowers levels like 50%, the big one is smoking”

“So strong inhibitors, they can increase levels like 5 to 10 times. they're the big medications we worry about so cipro the antibiotic so there's a real interaction there that can raise levels significantly luvox fluvoxamine”

“it is possible that it could be competitive use. I believe of cytochrome 1A2 because both caffeine and melatonin are metabolized by 1A2”

“valproic acid jacks up the levels of lamotrigine. So the way I remember it is when you combine those two medications, it's the dangerous interaction. So increasing lamotrigine is what we're scared of because of SJS. So whenever you're interacting using those medications, you should half the lamotrigine”

“since it's a salt, you eat too much salt, you're going to kick the lithium out. You eat too little salt, you're going to hold more lithium in. You take any NSAID, it's going to hold the lithium in. It can even make it go toxic if you take a lot of it”

“when it comes to the blood pressure medications, the ones that interfere with lithium, there's actually quite a few. And what I just say is you need to make sure you tell your primary care doctor or whoever prescribes you a blood pressure medication that you're on lithium”

“it's got too many drug-drug interactions, interacts with like a billion different other medications, and it interacts with itself. It's got a personality disorder. I hate it. So it takes forever to get to level”

“2D6 inhibitor, and thus can be used to increase effective dose of your Abilifying antenna and Aristata, which maxes out at a 15 to 20 milligram daily dose”

“Zoloft is highly variable in its metabolism, whereas Lexapro is really just broken down by 3A4 and 2C19. I always zone out once I start hearing the SIP stuff, but this is pretty simple. If someone has 2C19, there's a lot of variants”