Somatic complications of psychotropic medications in a patient with multiple CYP2 drug metabolism deficiencies

Gualberto Ruaño, C. Lee Blair, Bruce Bower, Andreas Windemuth, Mohan Kocherla, Yaraliz Aleman, Godfrey Pearlson, John W. Goethe, Harold I. Schwartz

Research output: Contribution to journalArticle

Abstract

A 54-year-old woman presented with severe anxiety, multiple somatic complaints, medication intolerance and adverse drug reactions (ADRs) to numerous prescribed psychotropic medications. Multiple drug metabolizing delciencies were suspected. Molecular analysis was performed for the CYP2 family of Cytochrome P450 (CYP450) drug metabolism isoenzymes by DNA typing CYP2D6, CYP2C9, and CYP2C19 genes. A multiple deficiency in CYP2 drug . metabolism was discovered. The patient was a double carrier of null alleles for CYP2B6, a carrier of a null allele for CYP2C19 and a carrier of a deficient allele for CYP2C9. These alleles were confirmed by Mendelian inheritance in her nuclear family, where her brother had a similar multigene CYP2 deficiency. The patient improved clinically with discontinuation of psychotropic medications, suggesting that much of her symptomatology was drug-induced. DNA typing for multigene CYP2 deficiencies is diagnostically useful in individuals with histories of multiple ADRs, which could be avoided by DNA-guided individualized prescription.

Original languageEnglish (US)
Pages (from-to)197-200
Number of pages4
JournalConnecticut Medicine
Volume71
Issue number4
StatePublished - Apr 2007
Externally publishedYes

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ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ruaño, G., Blair, C. L., Bower, B., Windemuth, A., Kocherla, M., Aleman, Y., Pearlson, G., Goethe, J. W., & Schwartz, H. I. (2007). Somatic complications of psychotropic medications in a patient with multiple CYP2 drug metabolism deficiencies. Connecticut Medicine, 71(4), 197-200.