Nonresponse to high-dose bupropion for depression in a patient carrying; CYP2B6; *6 and; CYP2C19; *17 variants: a case report.
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
 
ID 4606993
Author(s) Stäuble, Céline K; Lampert, Markus L; Mikoteit, Thorsten; Hatzinger, Martin; Hersberger, Kurt E; Meyer zu Schwabedissen, Henriette E
Author(s) at UniBasel Meyer zu Schwabedissen, Henriette
Stäuble, Céline
Hersberger, Kurt
Lampert, Markus Leopold
Year 2020
Title Nonresponse to high-dose bupropion for depression in a patient carrying; CYP2B6; *6 and; CYP2C19; *17 variants: a case report.
Journal Pharmacogenomics
Volume 21
Number 16
Pages / Article-Number 1145-1150
Keywords CYP2B6; CYP2C19; CYP450; antidepressant; bupropion; depression; pharmacogenomics; psychiatry
Abstract

We report the case of a patient with major depression treated with high-dose bupropion due to prior detected subtherapeutic blood concentrations at standard dosing. Pharmacogenetic panel testing identified the patient as a carrier of the; CYP2B6; *6 allele, which has been associated with reduced bupropion metabolism and decreased concentrations of the pharmacologically active metabolite hydroxybupropion. Interestingly, we also found the patient to be homozygous for the; CYP2C19; *17 allele, predicting an ultra rapid metabolizer phenotype. We propose a combined effect of the detected; CYP2C19; and; CYP2B6; genetic variants on bupropion metabolism. This case underlines the potential benefit of pre-emptive pharmacogenotyping but also the yet still fragmentary evidence making precise pharmacogenotype guided antidepressant selection and dosing challenging.

ISSN/ISBN 1744-8042
Full Text on edoc
Digital Object Identifier DOI 10.2217/pgs-2020-0087
PubMed ID http://www.ncbi.nlm.nih.gov/pubmed/33124517
   

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