Case report: Therapeutic drug monitoring and CYP2D6 phenoconversion in a protracted paroxetine intoxication
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F24%3A00080373" target="_blank" >RIV/65269705:_____/24:00080373 - isvavai.cz</a>
Alternative codes found
RIV/00216224:14110/24:00137176
Result on the web
<a href="https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1444857/full" target="_blank" >https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1444857/full</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.3389/fphar.2024.1444857" target="_blank" >10.3389/fphar.2024.1444857</a>
Alternative languages
Result language
angličtina
Original language name
Case report: Therapeutic drug monitoring and CYP2D6 phenoconversion in a protracted paroxetine intoxication
Original language description
Objective The cytochrome P450 2D6 (CYP2D6) is an enzyme involved in the oxidative biotransformation of various widely used drugs, including paroxetine, a substrate and strong inhibitor of the enzyme. The aim is to report on a case of protracted intoxication with paroxetine after a single overdose in a genotype-predicted intermediate CYP2D6 metabolizer.Observation A 49-year-old man was receiving chronic treatment for more than 6 years with paroxetine 60 mg/day for an indication of agoraphobia. The patient ingested fifty 20 mg tablets of paroxetine in a suicide attempt. The toxic plasma level, accompanied by delirium, persisted for approximately 1 month after the overdose. According to the genotype profile, the patient was evaluated as an intermediate metabolizer with reduced CYP2D6 enzyme activity.Conclusion As a consequence of the suicide attempt with overdose and the chronic paroxetine treatment that preceded it, phenoconversion to a poor metabolizer with very low CYP2D6 enzyme activity is suggested as contributing to an extremely long intoxication accompanied by delirium. Prolonged monitoring over a standard 24 h of both physical symptoms and drug plasma levels, together with a genetic profile assessment and phenoconversion consideration, is recommended after a single overdose in patients chronically treated with paroxetine.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30104 - Pharmacology and pharmacy
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2024
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Frontiers in Pharmacology
ISSN
1663-9812
e-ISSN
1663-9812
Volume of the periodical
15
Issue of the periodical within the volume
SEP 2024
Country of publishing house
CH - SWITZERLAND
Number of pages
7
Pages from-to
1444857
UT code for WoS article
001314626100001
EID of the result in the Scopus database
2-s2.0-85204304389