A study published in Clin Pharmacol Ther 2008 Feb: 83:322 examined the issue of how the metabolism of celexa (escitalopram) may influence clinical treatment. The study was reported in the May 2008 edition of the Journal Watch. Serum levels of celexa are significantly influenced by the CYP2C19 genotype. The researchers looked at different variants or polymorphisms associated with CYP2C19. The researchers discovered that different variants or polymorphisms of CYP2C19 produced either significantly higher levels or significantly lower serum levels of celexa depending upon the defect. The implications for clinical treatment are clear. Those patients who rapidly metabolize celexa would need a significantly higher clinical dose to achieve optimum serum levels. Those patients who metabolize much more slowly are at significant risk of developing side effects at standard clinical doses of celexa.
The Bottom Line: This study shows that different variants or polymorphisms of CYP2C19 can produce significantly higher or significantly lower serum levels of celexa then expected.
Sources: Clin Pharmacol Ther, See blogposts in: Psychiatric Disorders: Depression
Dr. Tanya Korkosz
Dr. Jeffrey Speller
Psychopharmacology Associates
of New England
www.psychopharmassociates.com