![]() ![]() ![]() ![]() This is probably related to p-glycoprotein, which kicks drugs like venlafaxine/desvenlafaxine (as well as other SSRI/SNRIs) out of the CNS rather than metabolization by CYP P450 enzymes in the liver (for venlafaxine it's CYP2D6 but for ODV it's UGT1A1 for ODV, a glucuronidation phase II pathway and not phase I/CYP P450 pathway, and one that doesn't come up on typical pharmacokinetic genetic tests). There's a recent study of this for desvenlafaxine as well. There's evidence that you can push up the venlafaxine dose above 375mg/day up to 600mg/day if plasma levels are low, and above those doses dopamine reuptake is also blocked in some patients. ![]() Venlafaxine has a dose-response relationship for MDD.
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