Abstract
The cytochrome enzyme P450 2D6 (CYP2D6) is thought to play a role in the human metabolism of fluvoxamine. Levomepromazine is a potent inhibitor of CYP2D6. We coadministered a low dosage of levomepromazine and fluvoxamine in 15 patients and found that the low dosage of levomepromazine was effective in counteracting the fluvoxamine-induced insomnia and did not increase plasma fluvoxamine levels. These results suggest that the inhibition of CYP2D6 by levomepromazine has little effect on fluvoxamine metabolism. Therefore, a low dosage of levomepromazine, used as a hypnotic agent, appears to be effective and safe when coadministered with fluvoxamine. Since this was a pilot study without a placebo control, a double-blind placebo-controlled study is needed to confirm our preliminary findings.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Aged
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Aged, 80 and over
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Cytochrome P-450 CYP2D6 Inhibitors
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Depressive Disorder, Major / blood
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Depressive Disorder, Major / drug therapy*
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Dose-Response Relationship, Drug
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Drug Therapy, Combination
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Female
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Fluvoxamine / administration & dosage
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Fluvoxamine / adverse effects
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Fluvoxamine / pharmacokinetics*
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Humans
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Male
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Methotrimeprazine / administration & dosage*
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Methotrimeprazine / adverse effects
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Middle Aged
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Panic Disorder / blood
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Panic Disorder / drug therapy*
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Sleep Initiation and Maintenance Disorders / blood
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Sleep Initiation and Maintenance Disorders / chemically induced
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Sleep Initiation and Maintenance Disorders / drug therapy
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Treatment Outcome
Substances
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Cytochrome P-450 CYP2D6 Inhibitors
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Methotrimeprazine
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Fluvoxamine