Article: article from journal or magazin.
Increased trimipramine plasma levels during fluvoxamine comedication.
European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology
Publication types: Case Reports ; Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
A depressive patient, a non-responder to trimipramine (TRI), was comedicated first with citalopram (CIT) and then with fluvoxamine (FLUV). Both the TRI-CIT and TRI-FLUV combination treatments led to a worsening of the depressive state and to the appearance of panic attacks. The addition of FLUV to TRI resulted in a twofold increase of the plasma levels of TRI and to a slight increase of its N-demethylated and 2-hydroxylated metabolites. These results suggest that the interaction between FLUV and TRI occurred at the level of cytochrome P-450IID6 and cytochrome P-450meph in this patient, phenotyped as an extensive metabolizer of both dextromethorphan and mephenytoin. The adverse effects were possibly due to (a) a pharmacokinetic interaction between CIT and FLUV with TRI and/or (b) alterations in serotonergic and/or dopaminergic neurotransmission.
Aged, Citalopram/adverse effects, Citalopram/therapeutic use, Depressive Disorder/blood, Depressive Disorder/complications, Dextromethorphan/pharmacokinetics, Drug Interactions, Female, Fluvoxamine/adverse effects, Fluvoxamine/therapeutic use, Humans, Mephenytoin/pharmacokinetics, Phenotype, Trimipramine/adverse effects, Trimipramine/blood
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