Clinical pharmacogenetics implementation consortium guideline (CPIC) for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants: 2016 update

Clin Pharmacol Ther. 2017 Jul;102(1):37-44. doi: 10.1002/cpt.597. Epub 2017 Feb 13.

Abstract

CYP2D6 and CYP2C19 polymorphisms affect the exposure, efficacy and safety of tricyclic antidepressants (TCAs), with some drugs being affected by CYP2D6 only (e.g., nortriptyline and desipramine) and others by both polymorphic enzymes (e.g., amitriptyline, clomipramine, doxepin, imipramine, and trimipramine). Evidence is presented for CYP2D6 and CYP2C19 genotype-directed dosing of TCAs. This document is an update to the 2012 Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6 and CYP2C19 Genotypes and Dosing of Tricyclic Antidepressants.

Publication types

  • Practice Guideline
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antidepressive Agents, Tricyclic* / adverse effects
  • Antidepressive Agents, Tricyclic* / pharmacokinetics
  • Cytochrome P-450 CYP2C19 / genetics*
  • Cytochrome P-450 CYP2D6 / genetics*
  • Dose-Response Relationship, Drug
  • Genotyping Techniques / methods*
  • Humans
  • Medication Therapy Management / standards*
  • Pharmacogenomic Variants / genetics*
  • Polymorphism, Genetic
  • Treatment Outcome

Substances

  • Antidepressive Agents, Tricyclic
  • Cytochrome P-450 CYP2C19
  • Cytochrome P-450 CYP2D6