top of page
psychopharmacology book

CYP2C19

​

“To See Nice Things (grow)”

​

10% of individuals are 2C19 ultrarapid metabolizers. 5% are poor metabolizers.

​

Conclusion: 2C19 genotyping is not typically ordered as a standalone test, but if 2C19 metabolizer genotype is known (e.g., from GeneSight or Genecept), the information can be put to good use when dosing (es)citalopram and sertraline. Knowledge of metabolizer status is not essential because these SSRIs can be titrated

CYP2C19 inducer interaction mnemonicby Dr Jason Cafer MD's psychopharmacology
CYP2C19 interaction inhibitors mnemonic by Dr Jason Cafer MD's psychopharmacology
CYP2C19 inducers mnemonic by Dr Jason Cafer MD's psychopharmacology
CYP2C19 interactions inhibitors CBC cannabidiol prozac fluoxetine diflucan fluconazole luvox fluvoxamine by Dr Jason Cafer MD psychopharmacology
CYP2C19 interactions substrates zoloft sertraline lexapro escitalopram celexa citalopram by Dr Jason Cafer MD psychopharmacology
CYP2C19 interactions substrates mnemonics addyi flibanserin coumadin warfarin doxepin amitriptyline omeprazole pantoprazole by Dr Jason Cafer MD psychopharmacology
CYP2C19 interaction mnemonics substrates soma carisoprodol luminal phenobarbital dilantin phenytoin valium diazepam onfi clobazam by Dr Jason Cafer MD psychopharmacology

2C19 Poor Metabolizers​

​

Individuals with a 2C19 PM  genotype clear 2C19 substrates slowly, leading to Higher blood levels (as if they were taking a 2C19 inHibitor). Standard doses of 2C19 substrates may be too strong.

CYP2C19 poor metabolizers by Dr Jason Cafer MD psychopharmacology

5% of population (20% of Asians) are 2C19 PMs.

 

*2C19 poor metabolizers should not exceed 20 mg of citalopram (QT prolongation).

2C19 Ultrarapid Metabolizers

​

2C19 UM individuals clear 2C19 substrates quickly, leading to low blood levels. These individuals are more likely to be non-responders to 2C19 substrates at standard doses.

CYP2C19 ultrarapid metabolizers by Dr Jason Cafer MD psychopharmacology
bottom of page