Combination therapy with venlafaxine and carbamazepine in depressive patients not responding to venlafaxine: pharmacokinetic and clinical aspects.

Détails

ID Serval
serval:BIB_9F19B17FFEA0
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Combination therapy with venlafaxine and carbamazepine in depressive patients not responding to venlafaxine: pharmacokinetic and clinical aspects.
Périodique
Journal of Psychopharmacology
Auteur(s)
Ciusani E., Zullino D.F., Eap C.B., Brawand-Amey M., Brocard M., Baumann P.
ISSN
0269-8811
Statut éditorial
Publié
Date de publication
2004
Peer-reviewed
Oui
Volume
18
Numéro
4
Pages
559-566
Langue
anglais
Notes
Publication types: Journal Article
Résumé
The chiral antidepressant venlafaxine (VEN) is both a serotonin and a norepinephrine uptake inhibitor. CYP2D6 and CYP3A4 contribute to its metabolism, which has been shown to be stereoselective. Ten CYP2D6 genotyped and depressive (F32x and F33x, ICD-10) patients participated in an open study on the pharmacokinetic and pharmacodynamic consequences of a carbamazepine augmentation in VEN non-responders. After an initial 4-week treatment with VEN (195 +/- 52 mg/day), the only poor metabolizer out of 10 depressive patients had the highest plasma concentrations of S-VEN and R-VEN, respectively, whereas those of R-O-demethyl-VEN were lowest. Five non-responders completed the second 4-week study period, during which they were submitted to a combined VEN-carbamazepine treatment. In the only non-responder to this combined treatment, there was a dramatic decrease of both enantiomers of VEN, O-demethylvenlafaxine, N-desmethylvenlafaxine and N, O-didesmethylvenlafaxine in plasma, which suggests non-compliance, although metabolic induction by carbamazepine cannot entirely be excluded. The administration of carbamazepine [mean +/- SD, range: 360 +/- 89 (200-400) mg/day] over 4 weeks did not result in a significant modification of the plasma concentrations of the enantiomers of VEN and its O- and N-demethylated metabolites in the other patients. In conclusion, these preliminary observations suggest that the combination of VEN and carbamazepine represents an interesting augmentation strategy by its efficacy, tolerance and absence of pharmacokinetic modifications. However, these findings should be verified in a more comprehensive study.
Mots-clé
Adolescent, Adult, Aged, Alleles, Antidepressive Agents, Second-Generation/pharmacokinetics, Antidepressive Agents, Second-Generation/therapeutic use, Carbamazepine/pharmacokinetics, Carbamazepine/therapeutic use, Cyclohexanols/pharmacokinetics, Cyclohexanols/therapeutic use, Cytochrome P-450 CYP2D6/genetics, Depressive Disorder/drug therapy, Depressive Disorder/psychology, Dose-Response Relationship, Drug, Drug Therapy, Combination, Female, Genotype, Humans, Male, Middle Aged, Psychiatric Status Rating Scales
Pubmed
Web of science
Création de la notice
10/03/2008 11:38
Dernière modification de la notice
03/03/2018 20:02
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