Imipramine diazepam

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. 

Imipramine, diazepam, codeine, erythromycin, morphine, tamoxifen, theophylhne, caffeine... 

Imipramine treatment resulted in a higher rate of remission of anxiety symptoms than trazodone, diazepam, or placebo (e.g., 73% versus 69% versus 66% versus 47%) in an 8-week controlled trial of DSM-III-diagnosed GAD patients. Antidepressants were more effective than diazepam or placebo in reducing psychic symptoms of anxiety. The use of TCAs generally is limited by bothersome adverse effects (e.g., sedation, orthostatic hypotension, anticholinergic effects, and weight gain). 

Venlafaxine extended release, duloxetine, paroxetine, and escitalopram are FDA approved for treatment of GAD. Sertraline is also effective. Acute response and remission rates are approximately 65% and 30%, respectively. Imipramine may be used when patients fail to respond to selective serotonin reuptake inhibitors (SSRIs). In one trial, diazepam, trazodone, and imipramine had greater anxiolytic activity than placebo. 

Rickels K, Downing R, Schweizer E, Hassman H. (1993). Antidepressants for the treatment of generalized anxiety disorder. A placebo-controlled comparison of imipramine, trazodone, and diazepam. Arch Gen Psychiatry. 50(11) 884-95. 

Fig. 4.3 CSF concentration/free (unbound) plasma concentration ratios for neutral and basic drugs 1, ritropirronium 2, atenolol 3, sulpiride 4, morphine 5, cimetidine 6, meto-prolol 7, atropine 8, tacrine 9, digoxin 10, propranolol 11, carbamazepine 12, ondansetron 13, diazepam 14, imipramine 15, digitonin 16, chlorpromazine and acidic drugs, a, salicylic acid b, ketoprofen c, oxyphenbutazone and d, indomethacin compared to log D.

Although several studies have found that the combination of imipramine and behavioral therapy may be superior to either treatment alone, no studies have specifically examined the effects of combining the behavioral techniques with BZDs (132, 133,134, 135,136, 137 and 138). In a review of the literature, however, Wardle found that diazepam was superior to placebo in three of four studies in which patients also received exposure therapy ( 139). Combined treatment with BZDs and CBT may be advantageous for some patients, but it must be carefully designed to avoid potential problems ( 140). 

C19 TCAs, citalopram (partly), warfarin, tolbutamide, phenytoin, diazepam Fluoxetine, fluvoxamine, sertraline, imipramine, ketoconozole, omeprazole Rifampin... 

Edder et al. reported the capillary supercritical fluid chromatography of basic drugs of abuse, namely nicotine, caffeine, methadone, cocaine, imipramine, codeine, diazepam, morphine, benzoylecgonine, papverine, narcotine, and strychnine [25]. They compared the separation of these drugs on DBS and DB wax columns. The chromatographic conditions included a carbon dioxide mobile phase and a flame-ionization detector. It was noted that on the DBS column, all peaks other than methadone and cocaine were separated. With the exception of benzoylecgonine and papaverine, all other peaks were separated on a DB wax column. A reproducibility of less than 5% was obtained with an internal standard method. The detection limits obtained were within 10-50 ppm on both the columns. A linearity of >0.99 was obtained for methadone, codeine, and morphine in the concentration range 10-1000 ppm. 

Substrates for this enzyme include (R)-mephobarbital, moclobemide, proguanil, diazepam, omeprazole, and imipramine, which do not show obvious structural or... 

The metabolic activity of CYP2C19 has most frequently been probed, both in vivo and in vitro, using (5)-mephenytoin hydroxylation or mephenytoin SIR ratios. However, other substrates for this enzyme, including diazepam and imipramine, have been identified that have the potential to be used as probes (90,91). However, the most widely used identified CYP2C19 substrate is omeprazole (92). 

Pharmacokinetic and pharmacodynamic profiles of olanzapine have been extensively reviewed (266). Olanzapine does not inhibit CYP isozymes, and no clinically significant metabolic interactions were found of olanzapine with aminophylline, biperiden, diazepam, ethanol, fluoxetine, imipramine, lithium, or R/S-warfarin. 

Amitriptjdine, aniylobarbitone, butobaibdtone, diazepam, imipramine, morphine, orphenadrine, paracetamol, p entobarb-itone, quinalbarbitone, saUcjlates... 

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