This study investigated whether the smokinginducible cytochrome P450 (CYP) 1A2 and the polymorphic CYP2D6 play significant roles in the metabolism of olanzapine and its clinical effects at steady-state treatment. Caffeine and debrisoquine were used as measures of CYP1A2 and CYP2D6, respectively. After drug therapy for 15 days, the effect of olanzapine on the activities of CYP1A2 and CYP2D6 was also examined. Seventeen psychiatric patients (9 men and 8 women) were orally administered olanzapine, at a mean +/- standard deviation (SD) dosage of 10 mg/d for all smokers (n = 8) and 7.5 +/- 2.5 mg/d (range, 5-10 mg) for nonsmokers (n = 9;p <0.01). The plasma concentration-to-dose (C:D) ratio was closely correlated to the CYP1A2 activity ( s = -0.89;p <0.0001). The mean urinary caffeine indexes of nonsmokers and smokers were 17 +/- 8 and 101 +/- 44, respectively, indicating that smoking had induced a sixfold higher CYP1A2 activity (p <0.0001). Likewise, the olanzapine plasma C:D ratio (ng.mL.mg) was about fivefold lower in smokers (7.9 +/- 2.6) than in nonsmokers (1.56 +/- 1.1;p <0.0001). On day 15 of the antipsychotic therapy, the percentage decrease in Brief Psychiatric Rating Scale (BPRS) total score relative to the predosing score (in the drug-free period) was higher for nonsmokers than for smokers (30.4 +/- 10% vs. 12.5 +/- 14%;p <0.01). Six nonsmokers and three smokers experienced side effects with olanzapine. After 15 days of drug treatment, olanzapine had caused significant (p <0.0001) and substantial CYP1A2 inhibition (by 50%) in comparison with predosing values, and such inhibition can contribute to adverse drug interactions. In conclusion, smoking-induced increased CYP1A2 activity significantly diminished plasma olanzapine concentrations and the antipsychotic effect of the drug. The performance of a simple caffeine test may assist in individualization of the olanzapine dosage.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1097/00004714-200304000-00003 | DOI Listing |
Sci Rep
January 2025
Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706, Santiago de Compostela, Spain.
Aripiprazole (ARI) is an atypical antipsychotic which is a substrate of P-glycoprotein (P-gp), a transmembrane glycoprotein that plays a crucial role in eliminating potentially harmful compounds from the organism. ARI once-monthly (AOM) is a long-acting injectable form which improves treatment compliance. Genetic polymorphisms in ABCB1 may lead to changes in P-gp function, leading to individual differences in drug disposition.
View Article and Find Full Text PDFToxicol Sci
January 2025
Takeda Development Center Americas, Inc, Cambridge, MA, USA.
The frequency of drug-induced liver injury (DILI) in clinical trials remains a challenge for drug developers despite advances in human hepatotoxicity models and improvements in reducing liver-related attrition in preclinical species. TAK-994, an oral orexin receptor 2 agonist, was withdrawn from phase II clinical trials due to the appearance of severe DILI. Here, we investigate the likely mechanism of TAK-994 DILI in hepatic cell culture systems examined cytotoxicity, mitochondrial toxicity, impact on drug transporter proteins, and covalent binding.
View Article and Find Full Text PDFBackground: Polyunsaturated fatty acids are metabolized by cytochrome P450 (CYP450) into anti-inflammatory, pro-resolving epoxides, which are rapidly converted to inactive and cytotoxic diols by soluble epoxide hydrolase (sEH). Increased CYP450-sEH metabolites are associated with worse cognition in type 2 diabetes mellitus (T2DM), and greater white matter hyperintensities (WMH) in patients with stroke. We examined whether the relationship between linoleic acid (LA)-derived CYP450-sEH metabolites (oxylipins) and small vessel disease (SVD) markers differ across diabetes status.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Background: Aging and the decline in sex steroid hormone (e.g., estrogen) are associated with a potential loss of its neuroprotective effects on the female brain.
View Article and Find Full Text PDFBackground: Alzheimer's Disease ("AD") presents a significant global health burden, often requiring medication management of comorbidities, some of which are metabolized by the polymorphic enzyme CYP2C9. We investigated the impact of CYP2C9 polymorphism on the reduction of Neuropsychiatric Inventory (NPI-12) scores following administration of IGC-AD1, comprising THC and melatonin, in AD patients.
Method: Thirteen Puerto Rican AD patients (mean age: 80.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!