Posted by yxibow on January 17, 2006, at 2:11:05
In reply to Re: Klonopin Dosing Schedule...half life, etc. » yxibow, posted by Phillipa on January 16, 2006, at 18:06:15
> Wow! I don't understand all the lingo at times. But are you saying that trilepal causes you to need higher doses of valium. My old pdoc said trileptal with valium would help with anxiety without raising dose of valium. Fondly, Phillipa
It depends on the person, but the cytochrome P450 (liver elimination system) in the body is very important especially for psychiatric drugs. Trileptal is known as what they call an "inducer" of an important enzyme, 3A4/5, so drugs that you take at the same time such as Seroquel and Valium which metabolize through 3A4, may have to be adjusted, say 10-20% higher than their original dose. That's because Trileptal is reducing their plasma levels, so a higher dose is as if you were taking the previous dose originally, give or take. It inhibits 2C19 which means it raises the plasma level of drugs that metabolize through that one, though I don't know if it is as important as 3A4.
Doctors should be informed about the P450 system -- it really wasn't studied until oh I dunno, the last 10 years or so, and is very important in determining drug interactions. That's why I think that especially if GPs instead of psychopharmacologists are to prescribe psychiatric drugs, they should take CME courses on the P450 system.
cheers
Jay
poster:yxibow
thread:599285
URL: http://www.dr-bob.org/babble/20060115/msgs/599905.html