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Clinical pharmacogenetics implementation consortium guideline (CPIC) for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants: 2016 update

Clinical Pharmacology & Therapeutics · 2016 · Vol. 102(1) · pp. 37–44

JK Hicks(Moffitt Cancer Center)Katrin Sangkuhl(Stanford University)JJ Swen(Leiden University Medical Center)VL Ellingrod(Michigan Medicine)Müller Dj(Centre for Addiction and Mental Health)Kazutaka Shimoda(Dokkyo Medical University)JR Bishop(University of Minnesota)E D Kharasch(Washington University in St. Louis)TC Skaar(Indiana University School of Medicine)Andrea Gaedigk(University of Missouri–Kansas City)Henry M. Dunnenberger(NorthShore University HealthSystem)Teri E. Klein(Stanford University)KE Caudle(St. Jude Children's Research Hospital)Julia Stingl✉(Federal Institute for Drugs and Medical Devices)

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Abstract

CYP2D6 and CYP2C19 polymorphisms affect the exposure, efficacy and safety of tricyclic antidepressants (TCAs), with some drugs being affected by CYP2D6 only (e.g., nortriptyline and desipramine) and others by both polymorphic enzymes (e.g., amitriptyline, clomipramine, doxepin, imipramine, and trimipramine). Evidence is presented for CYP2D6 and CYP2C19 genotype-directed dosing of TCAs. This document is an update to the 2012 Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6 and CYP2C19 Genotypes and Dosing of Tricyclic Antidepressants.

Pharmacogenetics and Drug Metabolism Cancer Treatment and Pharmacology Treatment of Major DepressionDosingPharmacogeneticsGuidelineCYP2C19CYP2D6TricyclicMedicinePharmacologyInternal medicineGenotype

MeSH terms

Pharmacogenomic VariantsAntidepressive Agents, TricyclicDose-Response Relationship, DrugHumansPolymorphism, GeneticTreatment OutcomeCytochrome P-450 CYP2D6Medication Therapy ManagementGenotyping TechniquesCytochrome P-450 CYP2C19