Background: The variability in drug response is highly complex and can be attributed to the polymedication,
genetic polymorphisms modulating drug-metabolizing enzyme activities (cytochromes P450,
CYP), physiological and environmental factors.” sentence could be revised as “The variability in drug response
is highly complex and can be attributed to the polymedication, genetic polymorphisms modulating drug-metabolizing
enzyme activities (cytochromeP450s (CYP)), physiological and environmental factors.
Objective: The main objective of this review is to deeply discuss the role of biotransformation in the occurrence
of antidepressant and anticonvulsant induced inter individual variabilities with the focus on genetic variations
and drug interactions.
Methods: An extensive search of the literature has been conducted related to biotransformation of the antidepressant
and anticonvulsant agents on relationships between genetic differences and drug interactions on available
databases. Following keywords are used for relevant articles: “metabolic enzyme”, “pharmacokinetic”, “antidepressant”,
“anticonvulsant”, “genetic variations”, “enzyme inhibition”, “enzyme induction” and also with a
list of all included antidepressant and anticonvulsants.
Results: In the present review, we provided an overview of documented clinically significant pharmacokinetic
drug interactions, physiological and environmental differences. We further discuss the significance of genetic
variations in drug metabolizing enzymes to underline the need for using the information on both genotype and
drug interactions towards implementing better clinical outcomes through personalized medicine in neurology
Conclusion: The present review clearly illustrates that interindividual differences in the biotransformation (including
genetic variability of the drug metabolizing enzymes, age, sex, diet) of the antidepressant and anticonvulsant
drugs, which are commonly prescribed medications globally, has a crucial role in the occurrence of adverse
effects and various drug responses. Therefore, the potential results of the drug-drug interactions and individual
genetic characteristics should always be considered to make pharmacotherapy safer and more effective,
as they have major clinical implications.