What are the Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for use of selective serotonin reuptake inhibitors (SSRIs) based on a patients CYP2D6 status?

Updated: Feb 03, 2021
  • Author: Ali Torkamani, PhD; Chief Editor: Keith K Vaux, MD  more...
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Answer

Answer

The Clinical Pharmacogenetics Implementation Consortium (CPIC) has provided guidelines that include the following [10] :

  • CYP2D6 ultrarapid metabolizers may have low or undetectable paroxetine plasma concentrations, when compared to CYP2D6 extensive metabolizers, which may result in therapeutic failure.
  • Adjustments to paroxetine or fluvoxamine therapy are not warranted based on CYP2D6 status for those who are CYP2D6 extensive or intermediate metabolizers.
  • Based on prescribing information, fluoxetine should be used with caution in patients with congenital long QT syndrome.

Dosing tables that were updated in October 2019 because of changes to the *10 allele functional status are available at the CPIC website. [7]


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