Importance of Chirality in Drug Therapy and Pharmacy Practice: Implications for Psychiatry

The implications of stereoselective pharmacokinetics and pharmacodynamics of chiral drugs is not only a curious scientific phenomena but has wide ranging implications in practical therapeutics, health care, and pharmacy and psychiatry practice. The impetus to market stereochemically pure "homochiral" drugs reinforces the need of pharmacists to educate themselves regarding issues of chirality and therapeutic decisions. Patient education and counseling should include the therapeutic advantages (reduction) in drug load, and in possible adverse effects. Choices made between homochiral and racemic drugs are not clear-cut and therefore policies and procedures in therapeutic review committees should begin to address these issues. This article reviews the concept of chirality and the stereoselective nature of drug action, and its impact on pharmacotherapeutics.