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Pharmacopsychiatry 2013; 46(02): 43-46
DOI: 10.1055/s-0032-1323752
Review
© Georg Thieme Verlag KG Stuttgart · New York

Influencing CYP Enzymes to Boost Psychiatric Treatment: A Review on Clinical Evidence

F. M. van Hasselt
1   Department of Pharmacy, Section Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, The Netherlands
2   Delta Chair on Pharmacotherapy in Psychiatric Patients, University of Groningen, Delta Psychiatric Hospital, Poortugaal, The Netherlands
,
Y. Coehorst
3   Lievensberg Ziekenhuis Bergen op Zoom, Bergen op Zoom, The Netherlands
4   GGZ Westelijk Noord-Brabant, Department of Long-Term Psychiatric Care Horst-Ligne, Bergen op Zoom, The Netherlands
,
B. Wilffert
1   Department of Pharmacy, Section Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, The Netherlands
,
A.J. M. Loonen
1   Department of Pharmacy, Section Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, The Netherlands
2   Delta Chair on Pharmacotherapy in Psychiatric Patients, University of Groningen, Delta Psychiatric Hospital, Poortugaal, The Netherlands
4   GGZ Westelijk Noord-Brabant, Department of Long-Term Psychiatric Care Horst-Ligne, Bergen op Zoom, The Netherlands
› Author Affiliations
Further Information

Publication History

received 02 December 2011
revised 09 August 2012

accepted 13 August 2012

Publication Date:
04 October 2012 (online)

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Abstract

Introduction:

Therapeutic drug monitoring to optimize blood plasma concentrations is advised for certain psychiatric drugs. The current standard is to change the dose based on the blood plasma concentration. We present an overview that blood plasma concentrations can also be influenced by adding co-medication based on pharmacokinetic knowledge.

Method:

We performed a systematic review in medical databases for pharmaco-enhancing strategies, and we present 2 cases on actively influencing CYP3A4 metabolism.

Results:

4 original studies were selected on strategies to influence CYP metabolism. 2 studies on influencing CYP2D6 metabolism, 2 studies on influencing CYP1A2 metabolism. In all studies an effect of this influence was present.

Discussion:

Ample clinical evidence is present, but shows promising results. Pharmacokinetic knowledge can and should be used in clinical settings to optimize pharmacotherapy for vulnerable patients. Also the access to expensive medication can be increased by reduction of high dosage schemes.

Key words

mental disorders - drug therapy - Cytochrome P-450 CYP3A
 

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