在一名CYP2D6慢代谢者和CYP2C19中间代谢者中与文拉法辛相关的心悸和乏力
Palpitations and Asthenia Associated with Venlafaxine in a CYP2D6 Poor Metabolizer and CYP2C19 Intermediate Metabolizer.
作者信息
Garcia Sofia, Schuh Michael, Cheema Anvir, Atwal Herjot, Atwal Paldeep S
机构信息
College of Pharmacy, University of Florida, Gainesville, FL, USA.
School of Health Sciences, College of Medicine, Mayo Clinic, Jacksonville, FL, USA.
出版信息
Case Rep Genet. 2017;2017:6236714. doi: 10.1155/2017/6236714. Epub 2017 Oct 16.
Abstract
Cardiotoxicity has been extensively reported in venlafaxine (VEN) overdoses. Asthenia is also among the common side effects described for this antidepressant. VEN is metabolized mainly by CYP2D6 and to a minor extent by CYP2C19 to the major active metabolite O-desmethylvenlafaxine (ODV). Altered pharmacokinetic parameters in patients with polymorphisms in the and genes that result in decreased enzymatic activity have been documented. Here we describe a patient case of VEN associated palpitations and asthenia. The patient takes VEN extended release 150 mg twice daily. Genotyping confirmed the patient is a poor metabolizer for CYP2D6 and an intermediate metabolizer for CYP2C19. We propose that the palpitations and asthenia are related to sustained VEN exposure due to reduced metabolism.
摘要
文拉法辛（VEN）过量使用时的心脏毒性已有大量报道。乏力也是这种抗抑郁药常见的副作用之一。VEN主要通过CYP2D6代谢，少量通过CYP2C19代谢为主要活性代谢物O-去甲基文拉法辛（ODV）。已有文献记载，参与 和 基因多态性导致酶活性降低的患者，其药代动力学参数发生改变。在此，我们描述一例与VEN相关的心悸和乏力患者病例。该患者每日两次服用150毫克缓释VEN。基因分型证实该患者是CYP2D6的慢代谢者和CYP2C19的中间代谢者。我们认为，心悸和乏力与代谢降低导致VEN持续暴露有关。
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