Factors associated with fluoxetine and norfluoxetine plasma concentrations and clinical response in Mexican patients with mental disorders
| Autor: | Cinthya Eloisa Chávez-Castillo, Julia Sagahón-Azúa, Silvia Romano-Moreno, Rosa del Carmen Milán-Segovia, Susanna Edith Medellín-Garibay, César Guillermo González-Salinas |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Olanzapine plasma concentrations CYP2D6 Genotype Pharmacogenomic Variants RM1-950 CYP2C19 Anxiety Pharmacology Medication Adherence Cytochrome P-450 Enzyme System Pharmacokinetics Fluoxetine medicine Cytochrome P-450 CYP3A Humans Drug Interactions General Pharmacology Toxicology and Pharmaceutics Mexico Active metabolite Depression business.industry Mental Disorders Therapeutic effect Original Articles Middle Aged Cytochrome P-450 CYP2C19 Treatment Outcome norfluoxetine Cytochrome P-450 CYP2D6 Neurology genetic factors Female Original Article Therapeutics. Pharmacology medicine.symptom business Selective Serotonin Reuptake Inhibitors Antipsychotic Agents medicine.drug |
| Zdroj: | Pharmacology Research & Perspectives Pharmacology Research & Perspectives, Vol 9, Iss 5, Pp n/a-n/a (2021) |
| ISSN: | 2052-1707 |
| Popis: | Over the last few years, fluoxetine has been one of the most prescribed medications for the treatment of diverse psychiatric conditions in Mexico. Fluoxetine therapeutic effect is consequence of the joint action of the parent drug and its active metabolite, norfluoxetine. However, the clinical efficacy of fluoxetine, can be affected due to diverse factors, such as drug‐drug interactions and the large interindividual variability in the pharmacokinetics of this drug. The aim of this study was to determine the factors associated with variability in plasma concentrations of fluoxetine and norfluoxetine and its association with the therapeutic response. Fluoxetine and norfluoxetine plasma concentrations were quantified by liquid chromatography in 81 Mexican patients with mental disorders; 25% of the patients had no medication adherence and 40% were below the reference range of fluoxetine plus norfluoxetine plasma concentrations. The results showed that concentrations can be affected by fluoxetine metabolism caused by CYP2D6 phenotype and the concomitant administration of olanzapine. Furthermore, CYP3A5 and CYP2C19 phenotype were associated with lower anxiety and depression control during treatment with fluoxetine. This study can be a starting point to elucidate the causes of fluoxetine variable response in Mexican patients with mental disorders, as well as to detect and support medication adherence. Factors associated with fluoxetine and norfluoxetine plasma concentrations and clinical response in Mexican patients with mental disorders “The results showed that fluoxetine and norfluoxetine concentrations can be affected by fluoxetine metabolism caused by CYP2D6 phenotype and the concomitant administration of olanzapine. Furthermore, CYP3A5 and CYP2C19 phenotype were associated with lower anxiety and depression control during treatment with fluoxetine” The figure shows the box plots, in which a significant difference was found in a) concentration of fluoxetine and b) Ratio norfluoxetine/fluoxetine, between groups of CYP2D6 phenotype. |
| Databáze: | OpenAIRE |
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