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Am J Psychiatry 1996; 153:311-320
Copyright © 1996 by American Psychiatric Association
Newer antidepressants and the cytochrome P450 system
CB Nemeroff, CL DeVane and BG Pollock
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.
OBJECTIVE: This review evaluates the in vitro and in vivo evidence for
inhibition of cytochrome P450 enzymes by the newer antidepressants and
provides clinical recommendations for avoiding and managing drug
interactions. METHOD: The international literature on the cytochrome P450
system and related drug interactions from 1966 to 1995 was reviewed. In
vitro studies, pharmacokinetic trials in human subjects, and case reports
were assessed. RESULTS: The newer antidepressants each inhibit a different
cluster of cytochrome P450 enzymes, which are of relevance to the potential
for drug interactions. Cytochrome P450 1A2 is inhibited by fluvoxamine and
is implicated in drug interactions with theophylline, clozapine, and
others. Fluoxetine, norfluoxetine, sertraline, and paroxetine are potent in
vitro inhibitors of cytochrome P450 2D6 and are capable of causing marked
elevations in plasma desipramine and nortriptyline concentrations.
Fluoxetine, sertraline, and fluvoxamine are believed to inhibit cytochrome
P450 2C because of observed interactions with phenytoin, diazepam, and
other drugs metabolized by these enzymes. Cytochrome P450 3A4 metabolizes
terfenadine, astemizole, carbamazepine, alprazolam, triazolam, and other
benzodiazepines. Plasma concentrations of these drugs have increased when
they are administered with fluvoxamine, nefazodone, fluoxetine, and
sertraline. CONCLUSIONS: The majority of the newer antidepressants are
associated with a risk for clinically significant drug interactions. A
rapidly growing body of literature provides evidence for a distinct profile
of cytochrome P450 inhibition and drug interaction risks by individual
antidepressants. These findings underscore the need for definitive in vivo
interaction studies of plasma from phenotyped patients treated with
clinically effective antidepressant doses of medication, for direct
comparative clinical studies, and for studies assessing the utility of
phenotyping in clinical practice.
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|
|
|
|
|
|
|
References
PsychiatryOnline CME,
May 1, 2007;
2007(1):
2 - 2.
[Full Text]
|
|
|
|
|
|
|
N. B. Sandson, S. C. Armstrong, and K. L. Cozza
An Overview of Psychotropic Drug-Drug Interactions
Psychosomatics,
October 1, 2005;
46(5):
464 - 494.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Kim, J. A. Johnson, and H. Derendorf
Differences in Drug Pharmacokinetics Between East Asians and Caucasians and the Role of Genetic Polymorphisms
J. Clin. Pharmacol.,
October 1, 2004;
44(10):
1083 - 1105.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. K. Malhotra, G. M. Murphy Jr., and J. L. Kennedy
Pharmacogenetics of Psychotropic Drug Response
Am J Psychiatry,
May 1, 2004;
161(5):
780 - 796.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Sreedharan and D. I. Mehta
Gastrointestinal Tract
Pediatrics,
April 1, 2004;
113(4/S1):
1044 - 1050.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. B. Currier, G. Molina, and M. Kato
A Prospective Trial of Sustained-Release Bupropion for Depression in HIV-Seropositive and AIDS Patients
Psychosomatics,
April 1, 2003;
44(2):
120 - 125.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. S. Kalgutkar, T. J. Taylor, K. Venkatakrishnan, and E. M. Isin
Assessment of the Contributions of CYP3A4 and CYP3A5 in the Metabolism of the Antipsychotic Agent Haloperidol to Its Potentially Neurotoxic Pyridinium Metabolite and Effect of Antidepressants on the Bioactivation Pathway
Drug Metab. Dispos.,
March 1, 2003;
31(3):
243 - 249.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Mokhlesi, J. B. Leikin, P. Murray, and T. C. Corbridge
Adult Toxicology in Critical Care: Part II: Specific Poisonings
Chest,
March 1, 2003;
123(3):
897 - 922.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. G Clay and M. M Adams
Pseudo-Parkinson Disease Secondary to Ritonavir-Buspirone Interaction
Ann. Pharmacother.,
February 1, 2003;
37(2):
202 - 205.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. L. Harden
The co-morbidity of depression and epilepsy: Epidemiology, etiology, and treatment
Neurology,
September 24, 2002;
59(90064):
S48 - 55.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
K. L. Wisner, B. L. Parry, and C. M. Piontek
Postpartum Depression
N. Engl. J. Med.,
July 18, 2002;
347(3):
194 - 199.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M J Le Nedelec and R J Rosengren
Methylphenidate inhibits cytochrome P450 in the Swiss Webster mouse
Human and Experimental Toxicology,
May 1, 2002;
21(5):
273 - 280.
[Abstract]
[PDF]
|
|
|
|
|
|
|
J. Sahi, E. L. Reyner, J. N. Bauman, K. Gueneva-Boucheva, J. E. Burleigh, and V. H. Thomas
The Effect of Bergamottin on Diazepam Plasma Levels and P450 Enzymes in Beagle Dogs
Drug Metab. Dispos.,
February 1, 2002;
30(2):
135 - 140.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Simon
Choosing a First-Line Antidepressant: Equal on Average Does Not Mean Equal for Everyone
JAMA,
December 19, 2001;
286(23):
3003 - 3004.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Psychiatric Aspects of HIV Care
AIDS Clinical Care,
November 1, 2001;
2001(1101):
6 - 6.
[Full Text]
|
|
|
|
|
|
|
M. H. Davidson
Treatment of the Elderly with 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitors: Focus on Drug Interactions
Journal of Cardiovascular Pharmacology and Therapeutics,
September 1, 2001;
6(3):
219 - 229.
[Abstract]
[PDF]
|
|
|
|
|
|
|
I N. Ferrier
Developments in mood stabilisers: Depression and public health
Br. Med. Bull.,
March 1, 2001;
57(1):
179 - 192.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Y. Hwang, J. E. Morgan, and M. F. Losconzcy
Clinical and Neuropsychological Profiles of Obsessive-Compulsive Schizophrenia: A Pilot Study
J Neuropsychiatry Clin Neurosci,
February 1, 2000;
12(1):
91 - 94.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
V. Andreoli, G. Carbognin, A. Abati, and G. Vantini
Reboxetine in the Treatment of Depression in the Elderly: Pilot Study
J Geriatr Psychiatry Neurol,
December 1, 1999;
12(4):
206 - 210.
[Abstract]
[PDF]
|
|
|
|
|
|
|
E. R. Lyon
A Review of the Effects of Nicotine on Schizophrenia and Antipsychotic Medications
Psychiatr Serv,
October 1, 1999;
50(10):
1346 - 1350.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. M. Carney, K. E. Freedland, R. C. Veith, and A. S. Jaffe
Can Treating Depression Reduce Mortality After an Acute Myocardial Infarction?
Psychosom Med,
September 1, 1999;
61(5):
666 - 675.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Understanding the Cytochrome P450 Isoenzyme System
Journal Watch Psychiatry,
July 1, 1999;
1999(701):
19 - 19.
[Full Text]
|
|
|
|
|
|
|
O. Spigset and B. Mårtensson
Fortnightly review: Drug treatment of depression
BMJ,
May 1, 1999;
318(7192):
1188 - 1191.
[Full Text]
|
|
|
|
|
|
|
M. Applegate
Cytochrome P450 Isoenzymes: Nursing Considerations
Journal of the American Psychiatric Nurses Association,
February 1, 1999;
5(1):
15 - 22.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. S. RAHMAN, J. J. GRACE, M. T. PATO, and B. PRIEST
Sertraline in the Treatment of Clozapine-Induced Obsessive-Compulsive Behavior
Am J Psychiatry,
November 1, 1998;
155(11):
1626f - 1626.
[Full Text]
|
|
|
|
|
|
|
W. T. Smith, P. D. Londborg, V. Glaudin, and J. R. Painter
Short-Term Augmentation of Fluoxetine With Clonazepam in the Treatment of Depression: A Double-Blind Study
Am J Psychiatry,
October 1, 1998;
155(10):
1339 - 1345.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
J. Avorn
Depression in the Elderly -- Falls and Pitfalls
N. Engl. J. Med.,
September 24, 1998;
339(13):
918 - 920.
[Full Text]
|
|
|
|
|
|
|
D. E. Adson, S. J. Crow, W. H. Meller, and R. M. Magraw
Potential Drug–Drug Interactions on a Tertiary-Care Hospital Consultation-Liaison Psychiatry Service
Psychosomatics,
August 1, 1998;
39(4):
360 - 365.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
M. I. Lucena, E. Blanco, M. A. Corrales, and M. L. Berthier
Ethics in forensic psychiatry.
Am J Psychiatry,
April 1, 1998;
155(4):
575 - 577.
[Full Text]
|
|
|
|
|
|
|
J. W. Smoller, M. H. Pollack, D. Systrom, and R. L. Kradin
Sertraline Effects on Dyspnea in Patients With Obstructive Airways Disease
Psychosomatics,
February 1, 1998;
39(1):
24 - 29.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
S. H. Preskorn
Debate resolved: there are differential effects of serotonin selective reuptake inhibitors on cytochrome P450 enzymes
J Psychopharmacol,
January 1, 1998;
12(4_suppl):
S89 - S97.
[Abstract]
[PDF]
|
|
|
|
|
|
|
F. Benazzi
Dangerous interaction with nefazodone added to fluoxetine, desipramine, venlafaxine, valproate and clonazepam combination therapy
J Psychopharmacol,
January 1, 1997;
11(2):
190 - 191.
[PDF]
|
|
|
|
|
|
|
C. A. Glod
Antidepressants and the Cytochrome P450 Enzymes
Journal of the American Psychiatric Nurses Association,
December 1, 1996;
2(6):
216 - 218.
[PDF]
|
|
|
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