Metabolism of antidepressant and neuroleptic drugs by cytochrome p450s: clinical and interethnic aspects

Clin Pharmacol Ther. 2007 Nov;82(5):606-9. doi: 10.1038/sj.clpt.6100358. Epub 2007 Sep 26.

Abstract

Early after the introduction of the classical tricyclic antidepressants and neuroleptics, it was shown that the plasma concentrations of these drugs varied between patients given the same dose. This variation is to a major extent due to the variation in the activity of cytochrome P450 (CYP) enzymes (cf. review by Bertilsson et al.1) During recent year(s), the different CYP enzymes catalyzing the metabolism of these drugs have been identified and the clinical relevance has also been identified. This brief review highlights the clinical importance and ethnic differences in the metabolism of these drugs.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antidepressive Agents / metabolism*
  • Antipsychotic Agents / metabolism*
  • Aryl Hydrocarbon Hydroxylases / genetics
  • Asian People / genetics
  • Clomipramine / metabolism
  • Cytochrome P-450 CYP1A2 / genetics
  • Cytochrome P-450 CYP2C19
  • Cytochrome P-450 CYP2D6 / genetics
  • Cytochrome P-450 CYP3A
  • Cytochrome P-450 Enzyme System / genetics*
  • Cytochrome P-450 Enzyme System / metabolism
  • Debrisoquin / metabolism
  • Drug Interactions
  • Ethnicity / genetics*
  • Humans
  • Mediterranean Region / ethnology
  • Metabolic Networks and Pathways
  • Mixed Function Oxygenases / genetics
  • Mutation
  • Nortriptyline / metabolism
  • Polymorphism, Genetic*
  • Sweden
  • White People / genetics*

Substances

  • Antidepressive Agents
  • Antipsychotic Agents
  • Cytochrome P-450 Enzyme System
  • Nortriptyline
  • Mixed Function Oxygenases
  • Aryl Hydrocarbon Hydroxylases
  • CYP2C19 protein, human
  • CYP3A5 protein, human
  • Cytochrome P-450 CYP1A2
  • Cytochrome P-450 CYP2C19
  • Cytochrome P-450 CYP2D6
  • Cytochrome P-450 CYP3A
  • CYP3A4 protein, human
  • Clomipramine
  • Debrisoquin