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A Poor Metabolizer for Cytochromes P450 2D6 and 2C19: A Case Report on Antidepressant Treatment

Published online by Cambridge University Press:  07 November 2014

Maria Johnson ,
Courtney Markham-Abedi ,
Margaret T. Susce ,
Elaina Murray-Carmichael ,
Stuart McCollum  and
Jose de Leon
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Abstract

Scientific literature has never described a poor metabolizer for both the cytochrome P450 (CYP) 2D6 and the CYP 2C19. They are expected to be rare (<1% in different ethnic groups) and prone to adverse drug reactions with many antidepressants. In an ongoing pharmacogenetic study, after genotyping 1,576 subjects in three Kentucky state hospitals we have found one poor metabolizer for both CYP 2D6 and CYP 2C19, which corresponds to a prevalence of 0.06% (95% Cl 0.01 to 0.36).The naturalistic antidepressant treatment of this poor metabolizer for both enzymes is described in this article. As genotyping reaches clinical practice, it will be interesting to prospectively establish whether mirtazapine is a reasonable choice as an antidepressant for these patients, as the data and this case suggest.

Type
Case Report
Information
CNS Spectrums , Volume 11 , Issue 10 , October 2006 , pp. 757 - 760
Copyright
Copyright © Cambridge University Press 2006

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