Drug interactions with newer antidepressants: role of human cytochromes P450.

Selective serotonin reuptake inhibitors and related antidepressant compounds have the secondary pharmacologic property of inhibiting the activity of human cytochrome P450 enzymes responsible for the oxidative metabolism of many drugs. A number of clinically important pharmacokinetic drug interactions are a consequence of these cytochrome inhibiting effects. This review evaluates the clinical implications of the metabolic profiles of the newer antidepressants, the relative activities of various new antidepressants as inhibitors of human cytochrome P450, and the various in vivo and in vitro methodologies that can be used for identification and quantification of drug interactions.