Clinically significant interactions with anti-addiction agents

Abstract

Anti-addiction agents are important psychopharmacological agents used to treat addiction to opioids (illicit and licit), alcohol and nicotine. The goal of treatment is to eliminate further use of the addicted drug by either preventing addicted drug reward or managing withdrawal symptoms experienced when the addicted drug is no longer used. Treatment success relies on adequate plasma and brain concentrations to produce the required pharmacodynamic response without toxic adverse effects. In this chapter, we describe clinically significant drug-drug interactions caused by changes in pharmacokinetics (induction or inhibition of metabolism) and pharmacodynamics (inhibited, additive or synergistic activity at the drug target) of the anti-addiction agents that alter treatment success, cause harmful effects and/or have led to recommendations from regulatory bodies regarding dosage adjustments or additional monitoring for patient safety. Clinicians need to be aware of the potential for these drug-drug interactions and prescribe and monitor patients for safety and efficacy as needed.