Inhibition of hepatic P-450 isoenzymes by serotonin selective reuptake inhibitors: in vitro and in vivo findings and their implications for patient care.
The effect on hepatic isoenzymes is emerging as the major clinically important distinguishing characteristic among the selective serotonin reuptake inhibitors (SSRIs). Although this fact has only recently gained widespread attention, the knowledge that some SSRIs inhibit hepatic metabolism dates back almost 20 years. This paper will first provide an overview of hepatic isoenzymes and then present the history and our current understanding of the effects of different SSRIs on different hepatic isoenzymes. Most of the attention in this area has focused on drug-drug interactions. This paper will also review recent work indicating that genetically determined differences in hepatic isoenzyme function can be risk factors in the development of a variety of diseases. The possible implications of this work relative to the long-term use of SSRIs will be discussed.
Preskorn
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Department of Psychiatry, University of Kansas School of Medicine in Wichita 67214.
Magnus
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D065607:Cytochrome P-450 Enzyme Inhibitors; D006801:Humans; D007527:Isoenzymes / Q000037:antagonists & inhibitors*; D008099:Liver / Q000187:drug effects / Q000201:enzymology*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
D065607:Cytochrome P-450 Enzyme Inhibitors; D007527:Isoenzymes; D017367:Selective Serotonin Reuptake Inhibitors