Liu Jiajia, Li Jinmeng, Zheng Ren, Zhang Ruoying
Department of Pharmacy, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, Zhejiang Province, China.
XiaoShan HangZhou Orthopedics TCM Hospital, Hangzhou, Zhejiang Province, China.
Ther Adv Psychopharmacol. 2025 Mar 24;15:20451253251328582. doi: 10.1177/20451253251328582. eCollection 2025.
Citalopram is a selective serotonin reuptake inhibitor used to treat depression and various anxiety disorders, which is mainly metabolized by the P450 (CYP) enzyme. Rifampin is a rifamycin with bactericidal activity against . Rifampin significantly induces the P450 (CYP) enzyme system, which makes it susceptible to potential drug interactions with other medications. However, there have been few reports on the possible interaction between rifampin and citalopram. We report a 76-year-old patient who had been taking citalopram 20 mg daily for long-term treatment of depression. After 2 months of rifampin treatment for tuberculosis, the patient presented with intractable depressive symptoms, insomnia, and a profound sense of hopelessness. The trough plasma concentration of citalopram was monitored, which was 8.19 ng/mL, and failed to reach the guideline-recommended effective therapeutic range (50-110 ng/mL). Based on the therapeutic drug monitoring results of citalopram, the dosage of citalopram was adjusted to 40 mg daily, resulting in a significant improvement in depressive symptoms. This case provides further evidence of a clinically significant interaction that may occur between rifampin and citalopram.
西酞普兰是一种用于治疗抑郁症和各种焦虑症的选择性5-羟色胺再摄取抑制剂，主要通过P450（CYP）酶代谢。利福平是一种对……具有杀菌活性的利福霉素。利福平可显著诱导P450（CYP）酶系统，这使其易于与其他药物发生潜在的药物相互作用。然而，关于利福平和西酞普兰之间可能的相互作用的报道很少。我们报告了一名76岁的患者，该患者长期每日服用20毫克西酞普兰治疗抑郁症。在接受利福平治疗肺结核2个月后，患者出现难治性抑郁症状、失眠和深深的绝望感。监测了西酞普兰的血药谷浓度，为8.19纳克/毫升，未达到指南推荐的有效治疗范围（50-110纳克/毫升）。根据西酞普兰的治疗药物监测结果，将西酞普兰的剂量调整为每日40毫克，抑郁症状得到显著改善。该病例进一步证明了利福平和西酞普兰之间可能发生具有临床意义的相互作用。
