Interaction between fluvoxamine and cotinine or caffeine.
We examined the relationships between plasma fluvoxamine concentrations and plasma levels of cotinine and caffeine, respectively, under steady-state conditions in 30 patients who met DSM-IV criteria for a major depressive disorder and who were being treated with fluvoxamine. The daily dosages of fluvoxamine ranged from 50 to 200 mg (mean +/- SD 108 +/- 42 mg). Eleven patients were smokers and the remaining 19 were nonsmokers. The plasma fluvoxamine concentrations were significantly higher in nonsmokers (0.92 +/- 0.40 ng/ml/mg) than in smokers (0.56 +/- 0.28 ng/ml/mg); in addition, a trend towards negative correlations was observed between the plasma fluvoxamine concentrations and the plasma cotinine levels, although it was not significant. Significant positive correlations were found between the plasma fluvoxamine concentrations and the plasma caffeine levels. These findings are compatible with those in earlier reports that cytochrome P450 1A2 plays a major role in fluvoxamine metabolism.
Yoshimura
Reiji
R
Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan. yoshi621@med.uoeh-u.ac.jp
Ueda
Nobuhisa
N
Nakamura
Jun
J
Eto
Seiji
S
Matsushita
Masakazu
M
D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002110:Caffeine / Q000097:blood; D000697:Central Nervous System Stimulants / Q000097:blood; D003367:Cotinine / Q000097:blood; D019388:Cytochrome P-450 CYP1A2 / Q000378:metabolism*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000378:metabolism; D004347:Drug Interactions; D005260:Female; D016666:Fluvoxamine / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking
D018687:Antidepressive Agents, Second-Generation; D000697:Central Nervous System Stimulants; D002110:Caffeine; D019388:Cytochrome P-450 CYP1A2; D003367:Cotinine; D016666:Fluvoxamine