精神药物与细胞色素P450 2C酶

Psychotropic Drugs and Cytochrome P450 2C Enzyme

阿米替林、氯丙咪嗪、西酞普兰、艾司两酞普兰、度洛西汀、吗氯贝胺和苯妥英经2C19酶代谢,氟伏沙明、氟西汀、帕罗西汀和丙戊酸钠抑制2C19酶,理论上升高这些药物血浓度,而卡马西平和苯妥英抑制2C19酶,理论上降低这些药物血浓度。丙戊酸钠、苯妥英、阿戈美拉汀经2C9酶代谢,氟西汀、氟伏沙明、帕罗西汀和丙戊酸钠抑制2C9酶,理论上增加这些药物血浓度,而卡马西平和巴比妥酸盐诱导2C9酶,降低这些药物血浓度。

Amitriptyline, clomipramine, citalopram, escitalopram, duloxetine, moclobemide and phenytoin are metabolized by cytochrome P450 2C19 enzyme, whereas cytochrome P450 2C19 enzyme is inhibited by fluvoxamine, fluoxetine, paroxetine and sodium valproate which can theoretically increase plasma concentrations of the drugs metabolized by cytochrome P450 2C19 enzyme and is induced by carbamazepine and phenytoin which can theoretically decrease plasma concentrations of the drugs also metabolized by cytochrome P450 2C19 enzyme. Sodium valproate, phenytoin and agomelatine are metabolized by cytochrome P450 2C9 enzyme, whereas cytochrome P450 2C9 enzyme is inhibited by fluoxetine, fluvoxamine, paroxetine and sodium valproate which can theoretically increase plasma concentrations of the drugs metabolized by cytochrome P450 2C9 enzyme and is induced by carbamazepine and barbiturate which can theoretically decrease plasma concentrations of the drugs also metabolized by cytochrome P450 2C9 enzyme.