Effects of genetic polymorphism of CYP1A2 inducibility on the steady-state plasma concentrations of trazodone and its active metabolite m-chlorophenylpiperazine in depressed Japanese patients

Pharmacol Toxicol. 2001 May;88(5):267-70. doi: 10.1034/j.1600-0773.2001.d01-115.x.

Abstract

The effects of a genetic polymorphism of inducibility of cytochrome P450 (CYP) 1A2 on the steady-state plasma concentrations of trazodone and its active metabolite, m-chlorophenylpiperazine, were studied in order to clarify if these steady-state plasma concentrations are dependent on the CYP1A2 polymorphism. Fifty-eight Japanese depressed patients received trazodone 150 mg/day at bedtime. The steady-state plasma concentrations of trazodone and m-chlorophenylpiperazine were measured in duplicate using high performance liquid chromatographic method, and were corrected to the mean body weight for analyses. A point mutation from guanine (wild type) to adenine (mutated type) at position -2964 in the 5'-flanking region of CYP1A2 gene was identified by polymerase chain reaction fragment length polymorphism method. The mean steady-state plasma concentration of trazodone, but not m-chlorophenylpiperazine was significantly (P<0.05) lower in smokers than in non-smokers. Twenty-two smokers had 16 homozygotes of the wild type allele, 5 heterozygotes of the wild type and mutated alleles, and one homozygote of the mutated allele. There was no significant difference in the mean steady-state plasma concentration of trazodone or m-chlorophenylpiperazine between smokers with no mutation and those with mutation, although one homozygote of the mutated allele had the highest steady-state plasma concentration of trazodone in smokers. The present study thus suggests that CYP1A2 polymorphism does not necessarily have predictive value of the steady-state plasma concentration of trazodone or m-chlorophenylpiperazine in most of the smokers treated with trazodone.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alleles
  • Antidepressive Agents, Second-Generation / blood*
  • Antidepressive Agents, Second-Generation / therapeutic use
  • Chromatography, High Pressure Liquid
  • Cytochrome P-450 CYP1A2 / biosynthesis
  • Cytochrome P-450 CYP1A2 / blood
  • Cytochrome P-450 CYP1A2 / genetics*
  • Depression / drug therapy*
  • Depression / metabolism
  • Dose-Response Relationship, Drug
  • Enzyme Induction / genetics
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Piperazines / blood*
  • Piperazines / pharmacokinetics*
  • Point Mutation / genetics
  • Polymerase Chain Reaction
  • Polymorphism, Genetic
  • Smoking / blood
  • Smoking / genetics
  • Time Factors
  • Trazodone / blood*
  • Trazodone / metabolism
  • Trazodone / pharmacokinetics*

Substances

  • Antidepressive Agents, Second-Generation
  • Piperazines
  • Cytochrome P-450 CYP1A2
  • 1-(3-chlorophenyl)piperazine
  • Trazodone