Severe Adverse Drug Reactions to Quetiapine in Two Patients Carrying; CYP2D6; *4 Variants: A Case Report

Stäuble, Céline K. and Lampert, Markus L. and Mikoteit, Thorsten and Hatzinger, Martin and Hersberger, Kurt E. and Meyer Zu Schwabedissen, Henriette E.. (2021) Severe Adverse Drug Reactions to Quetiapine in Two Patients Carrying; CYP2D6; *4 Variants: A Case Report. International Journal of Molecular Siences, 22 (12). p. 6480.

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We report two cases of patients who developed severe adverse drug reactions including persistent movement disorders, nausea, and vertigo during treatment with quetiapine at maximum daily doses ranging between 300 and 400 mg. The extensive hepatic metabolism of quetiapine is mainly attributed to cytochrome P450 3A4 (CYP3A4). However, there is recent evidence supporting the idea of CYP2D6 playing a role in the clearance of the quetiapine active metabolite norquetiapine. Interestingly, both patients we are reporting of are carriers of the CYP2D6 *4 variant, predicting an intermediate metabolizer phenotype. Additionally, co-medication with a known CYP2D6 inhibitor and renal impairment might have further affected quetiapine pharmacokinetics. The herein reported cases could spark a discussion on the potential impact of a patient's pharmacogenetic predisposition in the treatment with quetiapine. However, further studies are warranted to promote the adoption of pharmacogenetic testing for the prevention of drug-induced toxicities associated with quetiapine.
Faculties and Departments:05 Faculty of Science > Departement Pharmazeutische Wissenschaften > Pharmazie > Biopharmacy (Meyer zu Schwabedissen)
05 Faculty of Science > Departement Pharmazeutische Wissenschaften > Ehemalige Einheiten Pharmazie > Pharmaceutical Care (Hersberger)
UniBasel Contributors:Meyer zu Schwabedissen, Henriette and Stäuble, Céline and Lampert, Markus Leopold and Hersberger, Kurt E.
Item Type:Article, refereed
Article Subtype:Research Article
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:06 Sep 2021 10:21
Deposited On:06 Sep 2021 10:21

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