Magalhães Paulo, Alves Gilberto, LLerena Adrián, Falcão Amílcar
Drug Metab Pers Ther. 2015 Mar;30(1):3-17. doi: 10.1515/dmdi-2014-0011.
Venlafaxine (VEN) is an antidepressant agent widely used nowadays as an alternative to selective serotonin reuptake inhibitors (SSRIs), particularly for the treatment of SSRI-resistant depression. As the co-administration of antidepressant drugs with other medications is very common in clinical practice, the potential risk for pharmacokinetic and/or pharmacodynamic drug interactions that may be clinically meaningful increases. Bearing in mind that VEN has exhibited large variability in antidepressant response, besides the individual genetic background, several other factors may contribute to those variable clinical outcomes, such as the occurrence of significant drug-drug interactions. Indeed, the presence of drug interactions is possibly one of the major reasons for interindividual variability, and their anticipation should be considered in conjugation with other specific patients' characteristics to optimize the antidepressant therapy. Hence, a comprehensive overview of the pharmacokinetic- and pharmacodynamic-based drug interactions involving VEN is herein provided, particularly addressing their clinical relevance.
文拉法辛（VEN）是一种抗抑郁药，如今被广泛用作选择性5-羟色胺再摄取抑制剂（SSRI）的替代品，尤其用于治疗对SSRI耐药的抑郁症。由于在临床实践中抗抑郁药与其他药物联合使用非常普遍，具有临床意义的药代动力学和/或药效学药物相互作用的潜在风险增加。考虑到VEN在抗抑郁反应中表现出很大的变异性，除了个体遗传背景外，其他几个因素也可能导致这些可变的临床结果，例如显著的药物相互作用的发生。事实上，药物相互作用的存在可能是个体间变异性的主要原因之一，在优化抗抑郁治疗时，应结合其他特定的患者特征来考虑对其进行预测。因此，本文提供了基于药代动力学和药效学的涉及VEN的药物相互作用的全面概述，特别强调了它们的临床相关性。
