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Asymptomatic tricyclic toxicity associated with diltiazem

Published online by Cambridge University Press:  13 June 2014

Paul A Cotter ,
Peter W Raven  and
Marina Hudson
Peter W Raven
Affiliation:
Section of Metabolic Studies, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, England
Marina Hudson
Affiliation:
Maudsley Hospital, Denmark Hill, London SE5 8AE, England
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Abstract

Therapeutic drug monitoring of tricyclic antidepressants is a controversial issue. A case is reported in which a patient with recurrent depression developed asymptomatic tricyclic toxicity while on trimipramine, a tricyclic antidepressant, and diltiazem, a calcium channel blocker. A metabolic interaction involving cytochrome P450 3A (CYP3A) is postulated. It is suggested that routine therapeutic drug monitoring of tricyclic levels should be an essential part of the management of depression.

Keywords

DepressionTrimipramineTricyclic antidepressantsDiltiazemCalcium channel blockersCytochrome P450 enzymesTherapeutic drug monitoring
Type
Case Reports
Information
Irish Journal of Psychological Medicine , Volume 13 , Issue 4 , December 1996 , pp. 168 - 169
Copyright
Copyright © Cambridge University Press 1996

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