Citalopram CYP2C19 substrate

Substrates other than mephenytoin which have caused clinical disturbances in people with deficient CYP2C19 alleles include omeprazol (41), proguanil (42), and citalopram (43). Additional substrates listed (8) include clomipramine, imipramine, diazepam, and propanolol. 

Citalopram and escitalopram are major substrates of CYP2C19 and CYP3A4, and weakly inhibit CYP2D6. 

Citalopram Citalopram is a substrate of CYP2C19, and inhibition of its metabolism by fluconazole can result in serotonin syndrome, as occurred in two patients, who developed prolonged delirium without tremor, myoclonus, rigidity, or autonomic instability [30 ]. Serotonin toxicity in patients with cancers may not present with the classic constellation of signs and symptoms and delirium may be the only presenting feature. 

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