Nonenteral routes of administration for psychiatric medications - A literature review

In the treatment of psychiatric patients with complicating medical illness, clinicians may encounter patients who cannot take oral medications. The re view will acquaint the practicing clinical psychiatrist with psychotropic m edications available by nonenteral routes of administration. A computerized MEDLINE search was conducted of the literature 1981 to 1997 All articles c iting nonenteral routes of psychotropic medication administration,were revi ewed. The results are summarized according to drug class and specific route s of administration (intervenous, intramuscular, sublingual, rectal). Psych otropic medications now available comes from small case series or case repo rts. Intravenous and intramuscular routes of administration of psychotropic s are the most common. In addition, certain psychotropics are available by less common routes, such as sublingual or rectal administration. Considerat ion of alterations in pharmacokinetics, including poorer absorption and slo wer metabolism, are discussed. Clinicians may need to consider these novel routes of medication administration when dealing with patients unable to ta ke oral medications.