Drugs interfering with mitochondrial disorders

Results: Mitochondrion-toxic agents include corticosteroids, valproic acid, phenytoin, barbiturates, propofol, volatile anesthetics, nondepolarizing muscle relaxants, some local anesthetics, statins, fibrates, biguanides, glitazones, beta-blockers, amiodarone, some neuroleptics, some antibiotics, some chemotherapeutics, nucleoside reverse transcriptase inhibitors, and various other drugs. These agents should be avoided or given only under close monitoring, although some of them also exhibit beneficial effects, possibly due to the peculiarities of mitochondrial genetics. Typical side effects may be steroid myopathy, propofol syndrome, statin/fibrate myopathy, neuroleptic-induced extrapyramidal signs, or zidovudine myopathy. Conclusions: Avoiding or discontinuing mitochondrion-toxic drugs in MID patients can have a significant impact on the course and outcome of these patients.