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Jeffrey Alderman, PhD
Pfizer, Inc New York, NY

JAMA. 1993;270(11):1316.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—In their Editorial "Understanding Consequences of Concurrent Therapies," Peck et al¹ highlight some vital pharmacotherapeutic safety issues. However, a correct understanding of drug interactions often requires more careful distinctions among the drugs of a therapeutic class than are made in the editorial. A number of pharmacologic agents are substrates for the cytochrome P-450 2D6 enzyme, ie, they are extensively metabolized by this enzyme. Other therapeutic agents are known to be inhibitors of 2D6. Thus, the 2D6 enzyme is an important site for drug-drug interactions.

Peck et al point out that the 2D6 enzyme "is responsible for the metabolism of a great many drugs" including the "newer antidepressants (fluoxetine, sertraline, and paroxetine)." However, it is worth adding that there are substantial differences among these three selective serotonin reuptake inhibitors (SSRIs) with regard to their metabolism by 2D6 and their potency in inhibiting the 2D6 enzyme. Fluoxetine and . . . [Full Text PDF of this Article]

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