A case with occurring adverse effects when cross-over titration from fluvoxamine to paroxetine associated with increasing the plasma fluvoxamine level in major depressive disorder.

Abstract

Selective serotonin reuptake inhibitors (SSRIs) are first line drugs for treating not only depressive disorder but also anxiety disorder. Fluvoxamine, a SSRI, is mainly metabolized by cytochrome P450 (CYP) 2D6 and 1A2. However, paroxetine, an another SSRI is potent inhibitor for CYP 2D6. We report a case with depression whose plasma fluvoxamine level rapidly increased after the addition of paroxetine while switching from fluvoxamine to paroxetine. The case indicates that emerging adverse effects via the pharmacokinetic interaction of these drugs when switching patients from fluvoxamine to paroxetine can occur.

• Authors: Hikaru Hori, Reiji Yoshimura, Nobuhisa Ueda, Atsuko Ikenouchi-Sugita, Wakako Umene-Nakano, Jun Nakamura
• Journal: The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry (World J Biol Psychiatry) Vol. 10 Issue 4 Pt 2 Pg. 620-2 ( 2009) ISSN: 1814-1412 [Electronic] England
• PMID: 18609433 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antidepressive Agents, Second-Generation
• Cytochrome P-450 CYP2D6 Inhibitors
• Paroxetine
• Fluvoxamine

Topics

• Adult
• Antidepressive Agents, Second-Generation (adverse effects, pharmacokinetics, therapeutic use)
• Cytochrome P-450 CYP2D6 Inhibitors
• Depressive Disorder, Major (blood, drug therapy, psychology)
• Drug Interactions
• Drug Therapy, Combination
• Female
• Fluvoxamine (adverse effects, pharmacokinetics, therapeutic use)
• Humans
• Paroxetine (adverse effects, pharmacokinetics, therapeutic use)