Possible Interaction: Epinephrine and Antipsychotic Agents

“During intraoperative periods of stress, such as cardiopulmonary bypass and hypothermia, norepinephrine and epinephrine levels were 2-3 times higher in the neurolept patients, compared with the enflurane patients.”

“When epinephrine and antipsychotic drugs are administered in combination, β-2 adrenergic effects are thought to predominate and induce hypotension.”

“In Japan, however, it is important to note that the concomitant use of antipsychotics and adrenaline is an absolute contraindication because of the risk of adrenaline reversal.”

“Furthermore, the blocking and/or modulating actions of atypical antipsychotics on adrenaline , serotonine, histamine or acetyl-choline receptors all have the potential to contribute to secondary sexual problems.”

“During periods of stress such as intubation, skin incision and abdominal exploration, adrenaline levels were 4–6 times higher in the neurolept patients compared to the enflurane patients (p<0.01), in whom adrenaline levels were very stable.”

“In Japan, adrenaline is contraindicated for use in patients receiving antipsychotic therapy, because the combination of adrenaline and an antipsychotic is considered to cause severe hypotension; however, there is insufficient evidence supporting this claim.”

“The purpose of the present study was to clarify the changes in hemodynamics caused by drug interaction between adrenaline and an antipsychotic and to evaluate the safety of the combined use of adrenaline and an antipsychotic in an animal study.”

“In antipsychotic treated animals, the stress-induced depletion of adrenal adrenaline was considerably reduced.”