Amitriptyline pharmacokinetics and clinical response: II. Metabolic polymorphism assessed by hydroxylation of debrisoquine and mephenytoin.

Details

Serval ID
serval:BIB_F2CDEB6FC93E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Amitriptyline pharmacokinetics and clinical response: II. Metabolic polymorphism assessed by hydroxylation of debrisoquine and mephenytoin.
Journal
International clinical psychopharmacology
Author(s)
Baumann P., Jonzier-Perey M., Koeb L., Küpfer A., Tinguely D., Schöpf J.
ISSN
0268-1315 (Print)
ISSN-L
0268-1315
Publication state
Published
Issued date
04/1986
Peer-reviewed
Oui
Volume
1
Number
2
Pages
102-112
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
A subgroup of 16 out of 30 endogenous depressive inpatients (cf. part I), treated for 3 weeks with 150 mg amitriptyline (AT) daily, participated in a pharmacogenetic study: all were phenotyped with debrisoquine and 3 of them with mephenytoin. Four patients were found to be poor metabolizers (PMs) of debrisoquine and one of mephenytoin. Plasma levels of AT + NT (nortriptyline) were highest in the PMs of debrisoquine, but the ratio of hydroxylated metabolites to the parent compounds appeared to be lower in these subjects. From these data, it is speculated that, in the PM of mephenytoin, the demethylation of AT is impaired. In 12 patients, free plasma 10-hydroxy-AT (ATOH) and 10-hydroxy-NT (NTOH) were found to be bound to a similar extent to plasma proteins, but not so firmly as their parent compounds, by a factor of 6 and 4 respectively. While mean total plasma ATOH reached only 15% of the value of AT, total plasma NTOH was as high as NT. ATOH correlated significantly with its parent compound, but NTOH did not correlate with NT. No drug plasma levels/clinical relationship was found in this small group of patients, even when the hydroxylated metabolites were taken into account. Both poor and extensive metabolizers of debrisoquine responded to treatment. The debrisoquine-test appears to be a useful clinical tool for detecting in patients a genetic deficiency in the hydroxylation of AT-type drugs.
Keywords
Adult, Amitriptyline/analogs & derivatives, Amitriptyline/blood, Amitriptyline/metabolism, Amitriptyline/therapeutic use, Debrisoquin/metabolism, Depressive Disorder/drug therapy, Female, Humans, Hydantoins/metabolism, Hydroxylation, Isoquinolines/metabolism, Kinetics, Male, Mephenytoin/metabolism, Middle Aged, Nortriptyline/analogs & derivatives, Nortriptyline/blood, Nortriptyline/metabolism, Phenotype, Polymorphism, Genetic
Pubmed
Web of science
Create date
11/01/2021 12:35
Last modification date
15/04/2023 6:51
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