Carbamazepine augmentation in depressive patients non-responding to citalopram: a pharmacokinetic and clinical pilot study

Détails

ID Serval
serval:BIB_838EF92A0522
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Carbamazepine augmentation in depressive patients non-responding to citalopram: a pharmacokinetic and clinical pilot study
Périodique
European Neuropsychopharmacology
Auteur(s)
Steinacher L., Vandel P., Zullino D.F., Eap C.B., Brawand-Amey M., Baumann P.
ISSN
0924-977X
Statut éditorial
Publié
Date de publication
2002
Peer-reviewed
Oui
Volume
12
Numéro
3
Pages
255-260
Langue
anglais
Notes
Publication types: Journal Article
Résumé
Citalopram is a chiral antidepressant drug. Its eutomer, S-citalopram (escitalopram), has recently been introduced as an antidepressant. In an open pilot study, four outpatients and two inpatients with a major depressive episode (ICD-10), and who were nonresponders to a 4-week pretreatment with 40-60 mg/day citalopram, were comedicated for another 4-week period with carbamazepine (200-400 mg/day). Some of the patients suffered also from comorbidities: Phobic anxiety disorder with panic attacks (n=2), generalised anxiety disorder, alcohol abuse, dependent personality disorder, hypertension (n=1). After a 4-week augmentation therapy with carbamazepine, a significant (P<0.03) decrease of the plasma concentrations of S-citalopram and R-citalopram, by 27 and 31%, respectively, was observed. Apparently, the probable induction of CYP3A4 by carbamazepine results in a nonstereoselective increase in N-demethylation of citalopram. Moreover, there was a significant (P<0.03) decrease of the ratio S/R-citalopram propionic acid derivative, the formation of it being partly regulated by MAO-A and MAO-B. Already, within 1 week after addition of carbamazepine, there was a slight but significant (P<0.03) decrease of the MADRS depression scores, from 27.0+/-7.7 (mean+/-S.D.) to 23.3+/-6.6, and the final score on day 56 was 18.8+/-10.9. The treatment was generally well tolerated. There was no evidence of occurrence of a serotonin syndrome. After augmentation with carbamazepine, treatment related adverse events were: Nausea in one case, diarrhea in one case, and rash in two cases. In conclusion, the results of this pilot study suggest that carbamazepine augmentation of a citalopram treatment in previous nonresponders to citalopram may be clinically useful, but that in addition carbamazepine can lead to a decrease of the plasma concentrations of the active enantiomer escitalopram.
Mots-clé
Adult, Analysis of Variance, Antidepressive Agents, Second-Generation, Antimanic Agents, Carbamazepine, Citalopram, Depressive Disorder, Major, Drug Synergism, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Pilot Projects, Statistics, Nonparametric, Stereoisomerism
Pubmed
Web of science
Création de la notice
10/03/2008 10:39
Dernière modification de la notice
20/08/2019 14:43
Données d'usage