Dose-dependent pharmacokinetic interaction of clozapine and paroxetine in an extensive metabolizer

Pharmacopsychiatry
A A JoosR Ewald

Abstract

A 53-year-old patient suffering from delusional disorder developed an anticholinergic syndrome 19 days after initiation of paroxetine in addition to a steady dose of clozapine. The clozapine plasma concentration had doubled and was in the toxic range. On re-exposition with a lower clozapine dosage the increase was significantly lower. The importance of a dose-dependent interaction of both drugs is emphasized and a possible pharmacological explanation described. With regard to interactions of SSRIs and clozapine, fluvoxamine, a potent inhibitor of cytochrome P450 1A2, gives rise to higher clozapine levels at an earlier time, compared to other SSRIs (paroxetine, fluoxetine and sertraline), which are potent cytochrome P450 2D6 inhibitors.

Citations

Jul 29, 2004·The Annals of Pharmacotherapy·Raymond E FarahMoshe D Shai
Aug 23, 2018·Pharmacogenetics and Genomics·Caroline F ThornTeri E Klein
Sep 23, 2006·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Theo C Manschreck, Nealia L Khan
Apr 9, 2008·CNS Spectrums·Jonathan Meyer
Nov 23, 2016·Case Reports in Psychiatry·Jonathan M MeyerStephen M Stahl
Mar 1, 2016·Personalized Medicine·Dorgival Caetano, Irina Piatkov

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antipsychotic Drugs

Antipsychotic drugs are a class of medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia and bipolar disorder. Discover the latest research on antipsychotic drugs here

Related Papers

The World Journal of Biological Psychiatry : the Official Journal of the World Federation of Societies of Biological Psychiatry
Hikaru HoriJun Nakamura
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
H NordengO Spigset
© 2021 Meta ULC. All rights reserved