Document Detail


Comparison of the pharmacokinetics of venlafaxine extended release and desvenlafaxine in extensive and poor cytochrome P450 2D6 metabolizers.
MedLine Citation:
PMID:  19142106     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The goal of this study was to evaluate the impact of cytochrome P450 2D6 extensive metabolizer (EM) or poor metabolizer (PM) status on the pharmacokinetics of single doses of venlafaxine extended release (ER) and desvenlafaxine (administered as desvenlafaxine succinate) in healthy adults. METHODS: In an open-label, crossover study, 14 healthy volunteers (aged 18-55 years; 7 EMs and 7 PMs) received, in randomized sequence, single doses of venlafaxine ER 75 mg/d or desvenlafaxine 100 mg/d. Cytochrome P450 2D6 genotyping was performed, and plasma drug levels were measured. The arithmetic means and standard deviation (SD) for area under the plasma concentration-versus-time curve (AUC) and peak plasma concentration (Cmax) were calculated. Comparisons of AUC and Cmax between cytochrome P450 2D6 EMs and PMs were calculated using a Wilcoxon exact test. RESULTS: After administration of venlafaxine ER, mean Cmax and AUC of venlafaxine were significantly greater in PMs compared with EMs, whereas mean Cmax and AUC of its metabolite, desvenlafaxine, were significantly lower for PMs than for EMs (P = 0.001, all comparisons). In contrast, mean Cmax and AUC of desvenlafaxine after administration of desvenlafaxine were comparable between EMs and PMs. CONCLUSIONS: Cytochrome P450 2D6 genetic polymorphisms had no discernible impact on exposure to desvenlafaxine after desvenlafaxine administration; in contrast, compared with an EM phenotype, a PM phenotype had a significant effect on venlafaxine and desvenlafaxine plasma concentrations after venlafaxine ER administration. This reduced pharmacokinetic variability of desvenlafaxine may translate into better uniformity of response for patients receiving desvenlafaxine versus venlafaxine, but additional studies are required to test this hypothesis.
Authors:
Sheldon Preskorn; Albena Patroneva; Heather Silman; Qin Jiang; Jennifer A Isler; Michael E Burczynski; Saeeduddin Ahmed; Jeffrey Paul; Alice I Nichols
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of clinical psychopharmacology     Volume:  29     ISSN:  1533-712X     ISO Abbreviation:  J Clin Psychopharmacol     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-14     Completed Date:  2009-03-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109496     Medline TA:  J Clin Psychopharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  39-43     Citation Subset:  IM    
Affiliation:
Clinical Research Institute, Wichita, KS 67211, USA. spreskorn@cri-research.net
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00329186
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MeSH Terms
Descriptor/Qualifier:
Adult
Antidepressive Agents, Second-Generation / blood,  pharmacokinetics*
Area Under Curve
Cross-Over Studies
Cyclohexanols / blood,  pharmacokinetics*
Cytochrome P-450 CYP2D6 / genetics*,  metabolism*
Delayed-Action Preparations
Female
Genotype
Humans
Male
Middle Aged
Young Adult
Chemical
Reg. No./Substance:
0/Antidepressive Agents, Second-Generation; 0/Cyclohexanols; 0/Delayed-Action Preparations; 93413-62-8/O-desmethylvenlafaxine; 93413-69-5/venlafaxine; EC 1.14.14.1/Cytochrome P-450 CYP2D6

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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