Subscribe to RSS
DOI: 10.1055/s-2005-873159
Risperidone Half-Life in a Patient Taking Paroxetine
A Case ReportPublication History
Received: 29.3.2005
Revised: 29.5.2005
Accepted: 10.6.2005
Publication Date:
27 September 2005 (online)
This case report further establishes the inhibitory effects of paroxetine on risperidone (R) metabolism in a patient whose R was discontinued due to side effects. Baseline through levels in ng/ml were 33 for R, 9 for 9-hydroxyrisperidone (9-OHR) and 42 for the total moiety. The fourth morning after R discontinuation, levels were 4 for R, 1 for 9-OHR and 5 for the total moiety. The estimated half-lives were 23.8 hours for R, 22.8 hours for 9-OHR and 23.5 hours for the total moiety.
References
- 1 Agid O, Lerer B. Risperidone augmentation of paroxetine in a case of severe, treatment-refractory obsessive-compulsive disorder without comorbid psychopathology (letter). J Clin Psychiatry. 1999; 60 55-56
- 2 Alfaro C L, Lam Y W, Simpson J. et al . CYP2D6 status of extensive metabolizers after multiple-dose fluoxetine, fluvoxamine, paroxetine, or sertraline. J Clin Psychopharmacol. 1999; 19 155-163
- 3 Balant-Gorgia A E, Gex-Fabry M, Genet C. et al . Therapeutic drug monitoring of risperidone using a new rapid HPLC method: reappraisal of interindividual variability factors. Ther Drug Monitior. 1999; 21 105-115
- 4 Baumann P, Hiemke C, Uhlrich S. et al . The AGNP-TDM expert group consensus guidelines: Therapeutic drug monitoring in psychiatry. Pharmacopsychiatry. 2004; 37 243-256
- 5 Berecz R, LLerena A, de la Rubia A. et al . Relationship between risperidone and 9-hydroxy-risperidone plasma concentrations and CYP2D6 enzyme activity in psychiatric patients. Pharmacopsychiatry. 2002; 35 231-234
- 6 Bork J, Rogers T, Wedlund P. et al . A pilot study of risperidone metabolism: The role of cytochrome P450 2D6 and 3A. J Clin Psychiatry. 1999; 60 469-476
- 7 Chou W H, Yan F X, Robbins-Weilert D K. et al . Comparison of two CYP2D6 genotyping methods and assessments of genotype-phenotype relationships. Clin Chem. 2003; 49 542-551
- 8 de Leon J, Susce M T, Pan R M. et al . The CYP2D6 poor metabolizer phenotype may be associated with risperidone adverse drug reactions and discontinuation. J Clin Psychiatry. 2005; 66 15-27
- 9 Ereshefsky L. Pharmacokinetics and drug interactions: update for new antipsychotics. J Clin Psychiatry. 1996; 57 (Suppl 11) 12-25
- 10 Guzey C, Aamo T, Spigset O. Risperidone metabolism and the impact of being a cytochrome P450 2D6 ultrarapid metabolizer (letter). J Clin Psychiatry. 2000; 61 600-601
- 11 Huang M, Van Peer A, Woestenborghs R. et al . Pharmacokinetics of the novel antipsychotic agent risperidone and the prolactin response in healthy subjects. Clin Pharmacol Ther. 1993; 54 257-268
- 12 Kohnke M D, Griese E U, Stosser D. et al . Cytochrome P450 2D6 deficiency and its clinical relevance in a patient treated with risperidone. Pharmacopsychiatry. 2002; 35 116-118
- 13 Martin K, Begaud B, Verdoux H. et al . Patterns of risperidone prescription: a utilization study in south-west France. Acta Psychiatr Scand. 2004; 109 202-206
- 14 Megens A AHP, Awoteurs F HL, Schtte A. et al . Survey on pharmacodynamics of the new antipsychotic risperidone. Psychopharmacol. 1994; 114 9-23
- 15 O’Connor M, Silver H. Adding risperidone to selective serotonin reuptake inhibitor improves chronic depression (letter). J Clin Psychopharmacol. 1998; 18 89-91
- 16 Spina E, Avenoso A, Facciola G. et al . Plasma concentrations of risperidone and 9-hydroxyrisperidone during combined treatment with paroxetine. Ther Drug Monit. 2001; 23 223-227
- 17 Wang J S, Ruan Y, Taylor R M. et al . The brain entry of risperidone and 9-hydroxyrisperidone is greatly limited by p-glycoprotein. Int J Neuropsychopharmacology. 2004; 7 415-419
- 18 Wright J G, Boddy A V. All half-lives are wrong, but some half-lives are useful. Clin Pharmacokinet. 2001; 40 237-244
Jose de Leon, M.D.
Mental Health Research Center at Eastern State Hospital
627 West Fourth St.
Lexington
KY 40508, USA
Phone: +1 859 2467487
Fax: +1 859 246 7019
Email: jdeleon@uky.edu