Floxing and Clinical Psychopharmacology

There are two distinct and unrelated definitions of the word "floxing." In this podcast, the author of an editorial in the July-August 2024 issue of the Journal of Clinical Psychopharmacology discusses both, while providing an interesting lesson about potential drug-drug interactions that psychiatrists should be mindful of.   The author is Dr. Richard Shader, who is Founding Editor-in-Chief Emeritus of the Journal of Clinical Psychopharmacology. Dr. Shader describes the two definitions in a conversation with Dr. Julia Ann Koretski, a psychiatrist at Mass General Brigham Newton-Wellesley Hospital and Digital Editor of Journal of Clinical Psychopharmacology,   In recent decades in genetics and biology, floxing has meant to insert or sandwich a specific DNA sequence in a targeted gene. The current lay or street language term is, however, the topic of the podcast. Here, floxing refers to serious side effects attributed to the use of fluoroquinolone antibiotics. The Food and Drug Administration (FDA) refers to these effects as fluoroquinolone-associated disability or FQAD. The podcast focuses on those disabilities and the need for prescribers to guard against drug-drug interactions of the widely used antibiotic ciprofloxacin with widely prescribed psychotropic medications including clozapine, duloxetine, and fluvoxamine. Dr. Shader calls for case studies to demonstrate toxicity and to ferret out causality. Clinicians should direct instances of interaction to FDA's reporting portal www.fda.gov/medwatch.