Citalopram and escitalopram are selective serotonin reuptake inhibitors (SSRI) used to treat depression. The activity of CYP2C19 affects both the tolerability and efficacy of both drugs.
Patient selection: therapy with citalopram or escitalopram
Evaluation: CYP2C19 activity by pharmacogenetic therapy
Serious side effect: any untoward medical occurrence that results in death, hospitalization, a life-threatening event, referral to a specialist physician, or prolongation of a hospitalization.
Poor metabolizers show:
(1) multiple side effects
(2) poor compliance
(3) frequent treatment changes
Reasons for low CYP2C19 activity:
(1) genotype (based on *1, *2 and *17)
(2) drug interaction
Genotype of CYP2C19
Phenotype
*1/*1
normal metabolizer
*1/*2
intermediate metabolizer
*2/*17
intermediate metabolizer
*2/*2
poor/slow metabolizer
*1/*17
rapid metabolizer
*17/*17
ultrarapid
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