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Re: Clomipramine - Augmentation options? » SLS

Posted by tensor on January 20, 2013, at 6:34:40

In reply to Re: Clomipramine - Augmentation options? » tensor, posted by SLS on January 20, 2013, at 6:24:22

> > I know fluvoxamine is used in combination with clomipramine, it makes clomipramine more serotonergic due to a metabolic change.
>
> Hmm. Interesting. I didn't know that. You are right, of course.
>
> Which metabolic route (enzyme) is responsible for this? I know that CYP3A4 is inhibited by fluvoxamine, but that should not affect a TCA, should it? Is clomipramine different than the other TCAs in this regard?

Fluvoxamine inhibits CYP1A2. Which is the enzyme breaking down clomipramine to desmethyl-clomipramine (which is a strong NE reuptake inhibitor.) This results in higher clomipramine levels and stronger serotonin action.

/tensor

> I hope you slept well.

Thanks, I did :-)


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