Drug Interactions With Newer Antidepressants: Role of Human Cytochromes P450

Selective serotonin reuptake inhibitors and related antidepressant compounds have the secondarypharmacologic property of inhibiting the activity of human cytochrome P450 enzymes responsible forthe oxidative metabolism of many drugs. A number of clinically important pharmacokinetic drug interactionsare a consequence of these cytochrome inhibiting effects. This review evaluates the clinicalimplications of the metabolic profiles of the newer antidepressants, the relative activities of variousnew antidepressants as inhibitors of human cytochrome P450, and the various in vivo and in vitromethodologies that can be used for identification and quantification of drug interactions.