Paroxetine shifts imipramine metabolism

Psychiatry Res. 1996 Jan 31;59(3):189-96. doi: 10.1016/0165-1781(95)02822-6.

Abstract

The combination of selective serotonin reuptake inhibitors with tricyclic antidepressants has proven useful in treatment-resistant depression but has the potential for adverse drug-drug interactions. In the present study, the metabolism of a single dose of imipramine was studied before and after treatment with paroxetine. Paroxetine induced significant elevations of approximately 50% in half-life, area under the curve, and Cmax of imipramine and decreased clearance twofold. The effects on desipramine pharmacokinetics were even more pronounced. These findings indicate a significant interaction of paroxetine with the CYP2D6 isoenzyme.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Antidepressive Agents, Tricyclic / blood
  • Antidepressive Agents, Tricyclic / metabolism*
  • Antidepressive Agents, Tricyclic / therapeutic use*
  • Cytochrome P-450 Enzyme System / metabolism
  • Depressive Disorder / blood
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / psychology
  • Desipramine / metabolism
  • Drug Synergism
  • Humans
  • Imipramine / blood
  • Imipramine / metabolism*
  • Imipramine / therapeutic use*
  • Male
  • Middle Aged
  • Paroxetine / blood
  • Paroxetine / pharmacokinetics
  • Paroxetine / pharmacology*
  • Selective Serotonin Reuptake Inhibitors / pharmacology*

Substances

  • Antidepressive Agents, Tricyclic
  • Serotonin Uptake Inhibitors
  • Paroxetine
  • Cytochrome P-450 Enzyme System
  • Imipramine
  • Desipramine