Metabolism and pharmacokinetics of selective serotonin reuptake inhibitors.
1. Five drugs with the predominant pharmacologic effect of inhibiting the neuronal reuptake of serotonin are available worldwide for clinical use. This class of psychoactive drugs, known as selective serotonin reuptake inhibitors (SSRIs), is comprised of fluoxetine, sertraline, paroxetine, fluvoxamine, and citalopram. 2. The SSRIs appear to share similar pharmacodynamic properties which translate to efficacy in the treatment of depression and anxiety syndromes. The drugs are differentiated by their pharmacokinetic properties with regard to stereochemistry, metabolism, inhibition of cytochrome enzymes, and participation in drug-drug interactions. Studies focusing on the relationship of plasma drug concentration to therapeutic and adverse effects have not confirmed the value of plasma concentration monitoring. 3. This review summarizes the metabolism and relevant pharmacokinetic properties of the SSRIs.
DeVane
C L
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Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425, USA.
D000367:Age Factors; D000818:Animals; D014151:Anti-Anxiety Agents / Q000378:metabolism / Q000493:pharmacokinetics; D018687:Antidepressive Agents, Second-Generation / Q000378:metabolism* / Q000493:pharmacokinetics; D000929:Antidepressive Agents, Tricyclic / Q000378:metabolism* / Q000493:pharmacokinetics; D001007:Anxiety / Q000188:drug therapy / Q000378:metabolism; D003863:Depression / Q000188:drug therapy / Q000378:metabolism; D004347:Drug Interactions; D006801:Humans; D017367:Selective Serotonin Reuptake Inhibitors / Q000378:metabolism* / Q000493:pharmacokinetics; D012737:Sex Factors
D014151:Anti-Anxiety Agents; D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors