Pharmacological Interactions between Psychotropic Drugs and Anesthetics: Risks and Specifics of Perioperative Management

Background: t he issue of anesthetic management in patients with mental disorders is gaining clinical importance due to the increasing number of surgical interventions in this population. Pharmacological interactions between psychotropic drugs and anesthetics can significantly affect the depth, duration, and safety of anesthesia. These aspects require a comprehensive analysis from the perspective of modern psychopharmacology and anesthesiology. The aim of review was to analyze current research on the interactions between psychopharmacological agents and anesthetics, with an emphasis on identifying clinically relevant patterns and potential risks during the perioperative period. Materials and Methods: the search for foreign articles was conducted in the PsycINFO, PubMed, and SciSpace databases using a keyword search query: “interactions”, “side effects”, “anesthesia”, “psychopharmacology”, “pharmacokinetics” in various combinations. Russian-language articles were selected by searching the database eLibrary.ru by keywords: “interaction”, “anesthetics”, “anesthesia”, “psychopharmacology”. Discussion: the analysis of recent studies demonstrates that psychopharmacological agents can significantly alter the effects of anesthetics, presenting both therapeutic opportunities and clinical risks. Researchers emphasize mechanisms of pharmacokinetic modulation via cytochrome P450 isoenzymes and significant changes in central neurotransmitter systems. Particular attention is required for interactions associated with excessive sedation, serotonin syndrome, and cardiotoxic effects. Conclusion: understanding and accounting for interactions between psychotropic drugs and anesthetics not only enhances anesthesia safety but also contributes to better quality of care, which is particularly important for vulnerable psychiatric patients. Further studies are necessary to develop more precise algorithms for personalized perioperative care.