[Significance of hepatic cytochrome P450 enzymes for psychopharmacology].
Nearly all psychotropic drugs are metabolized by hepatic cytochrome P450-enzymes. In humans, there are 5 isoenzymes involved in this process. The activity of these enzymes can be modulated by a number of commonly used drugs, yielding potentially hazardous interactions. Most of the recently introduced selective serotonin reuptake inhibitors are potent inhibitors of cytochrome P450 enzymes. Thus, the plasma concentrations of tricyclic antidepressants or clozapine might be elevated into toxic levels. In contrast, carbamazepine induces most of the isoenzymes. This potentiates the elimination of tricyclics and antipsychotics and might cause a serious risk for the recurrence of depressive or psychotic symptoms. Moreover, 5-10% of the population are slow metabolizers of CYP2D6. This group is prone to increased adverse effects of moderately dosed medication. This review systematically points out the reported or predicted pharmacokinetic drug interactions in psychopharmacology focussing on clinical significance.
Normann
C
C
Abteilung für Psychiatrie und Psychotherapie, Klinikum der Albert-Ludwigs-Universität, Freiburg.
Hesslinger
B
B
Bauer
J
J
Berger
M
M
Walden
J
J
D065607:Cytochrome P-450 Enzyme Inhibitors; D003577:Cytochrome P-450 Enzyme System / Q000502:physiology*; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000201:enzymology*; D008657:Metabolic Clearance Rate / Q000187:drug effects; D011619:Psychotropic Drugs / Q000493:pharmacokinetics*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects
D065607:Cytochrome P-450 Enzyme Inhibitors; D003577:Cytochrome P-450 Enzyme System; D011619:Psychotropic Drugs; D017367:Selective Serotonin Reuptake Inhibitors
Die Bedeutung des hepatischen Cytochrom-P450-Systems für die Psychopharmakologie.