Buster Mannheimer

Buster Mannheimer

Senior Lecturer/Senior Physician | Docent
Visiting address: Karolinska Institutet/Institutionen för klinisk forskning och utb, SÖS, 11883 Stockholm
Postal address: S1 Klinisk forskning och utbildning, Södersjukhuset, S1 KI SÖS Läkarprogrammet Klinisk medicin 1, 171 77 Stockholm

About me

  • My research involves the adverse effects following drug treatment. Lately,
    two major aims have been to study warfarin interactions and different aspects
    of drug related hyponatremia.
    I was born in 1973 and educated at the University of Gothenburg taking my
    doctors exam in 2002. I then performed my specialization at Södersjukhuset,
    qualifying as a specialist in Internal Medicine in 2007 and as a specialist
    in Endocrinology and Diabetes in 2010. Since my specialization I have
    continued working at Södersjukhuset and been a consultant since 2016.
    I defended my thesis at Karolinska Institutet in 2009 becoming an Associate
    Professor in 2016. Since 2018 I’m part time employed as the Director of
    Doctoral Education of the Department of Clinical Science and Education at
    Karolinska Institutet.


  • In 2009 I defended my thesis ”Drug-related problems with special emphasis
    on drug-drug interactions”. The thesis includes pharmacogenetic,
    pharmacokinetic as well as epidemiologic aspects on mainly adverse effects
    due to the treatment with psychotropic drugs. Since then I have moved towards
    a mainly register based research. Several projects have included the use of
    the Swedish Prescribed Drug Register (SPDR) and investigated prescription
    patterns but also associations with clinical outcome.
    Combining the SPDR with Auricula and Journalia, registries containing data on
    individuals treated with anticoagulantia we have established a cohort of
    over 100 000 patients treated with warfarin. The cohort enables a unique
    epidemiologic therapeutic drug monitoring approach, efficiently targeting the
    effects of any added drug with regard to changes in INR and warfarin doses.
    So far, we have published data on the effects of initiating carbamazepine and
    amiodarone. Four of five warfarin-treated patients in whom cotreatment with
    carbamazepine was initiated experienced subtherapeutic anticoagulative effect
    within 3–5 weeks. The warfarin dose was subsequently increased by 49 %. For
    amiodarone, a powerful inhibitor of enzymes of importance for warfarin
    metabolism, the opposite effect was evident with supratherapeutic INR and a
    subsequent average 25 % compensatory dose decrease. This knowledge is
    important to avoid severe bleedings or thromboembolic complications due to
    changes in anticoagulation caused by interactions. Onwards we plan to
    investigate the effect of several additional drugs.
    Another project focuses on different aspects of hyponatremia. We recently
    established a cohort of over 14 000 individuals hospitalized due to
    hyponatremia. Using a case control design we studied the associations between
    antidepressants and hospitalization due to hyponatremia. The results
    indicated a strong association between selective serotonin reuptake
    inhibitors (SSRIs) and venlafaxine, and hospitalization due to hyponatremia
    exclusively related to newly initiated treatment. Consequently, in patients
    with clinically significant hyponatremia with newly initiated treatment with
    SSRI or venlafaxine, an alternative treatment should be considered. For
    patients with ongoing antidepressant treatment, other causes should be
    explored. The project has a lot of potential. One future aim is to
    investigate the effects of other drugs. Another is to follow the cohort over
    time which will be interesting in several ways. For example we plan to
    compare the cases and controls with regard to mortality.


All other publications


  • Senior Lecturer/Senior Physician, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 2024-

Degrees and Education

  • Docent, Karolinska Institutet, 2016
  • Degree Of Doctor Of Philosophy, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 2009

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