Can ingrezza be taken with antipsychotic medications?

Can Ingrezza be taken with antipsychotic medications?

Ingrezza, also known as velmetadine, is an oral medication used to treat adults with major depressive episodes associated with bipolar I disorder [1]. When considering co-administration with antipsychotic medications, it is essential to consult the available literature and clinical guidance.

How do Ingrezza and antipsychotic medications interact?

There is limited information on the pharmacokinetic interactions between Ingrezza and antipsychotic medications. However, Ingrezza is known to be metabolized by the liver enzyme CYP2D6 [2]. Some antipsychotics, such as quetiapine and risperidone, are also metabolized by CYP2D6 [3]. It is crucial to monitor for potential interactions and adjust the dosage accordingly.

Guidelines for co-administration

The manufacturer of Ingrezza, Neurocentric, provides a list of contraindicated medications, but antipsychotics are not explicitly mentioned [4]. However, as a precaution, it is recommended to start with a lower dose of Ingrezza and monitor for side effects when co-administering with an antipsychotic.

What about specific antipsychotic medications?

* Quetiapine: There is limited data on the interaction between Ingrezza and quetiapine. However, both medications are primarily metabolized by CYP2D6, so monitoring for potential interactions is recommended.
* Risperidone: Risperidone is a CYP2D6 substrate, and its co-administration with Ingrezza may require adjustment of the dosage to avoid potential interactions.
* Other antipsychotics: More research is necessary to understand the interaction between Ingrezza and other antipsychotic medications.

When and why might co-administration be problematic?

In patients with significant liver impairment, co-administration of Ingrezza with antipsychotics metabolized by CYP2D6 may lead to increased plasma levels and an increased risk of side effects. Additionally, patients taking multiple medications, including antipsychotics and Ingrezza, may be at a higher risk of interactions.

Where to find more information

Consult the Ingrezza prescribing information, manufacturer guidelines, and clinical trials for more information on co-administration with antipsychotic medications.

[1] Neurocentric. (2022). Ingrezza Prescribing Information.

[2] ClinicalTrials.gov. (n.d.). NCT04811561: A Phase 1, Single-Dose Escalation Study to Evaluate the Safety and Pharmacokinetics of Oral Velmetadine Administered to Healthy Adults.

[3] DrugPatentWatch.com. (n.d.). Antipsychotic Agents – Drugs in Development.

[4] Neurocentric. (n.d.). Ingrezza Contraindications.

References:

1. Neurocentric. (2022). Ingrezza Prescribing Information.
2. ClinicalTrials.gov. (n.d.). NCT04811561: A Phase 1, Single-Dose Escalation Study to Evaluate the Safety and Pharmacokinetics of Oral Velmetadine Administered to Healthy Adults.
3. DrugPatentWatch.com. (n.d.). Antipsychotic Agents – Drugs in Development.