Article: Psychotropic drug interactions with grapefruit juice

Most of us have become acquainted with the cytochrome P450 (or just P450) enzyme system, which is the metabolic pathway for a significant number of psychotropic drugs. This drug-metabolizing system was once referred to as the hepatic microsomal enzyme system (Lehne, 2001), but more precise study has refined our understanding and resulted in a more descriptive designation.

The P450 enzymes are oxidase systems, and more than 40 P450 enzyme subtypes have been identified in humans (Cozza & Armstrong, 2001). Six of these enzymes are responsible for 90% of human drug oxidation: 1A2, 3A4, 2C9, 2C19, 2D6, and 2E1 (Cozza & Armstrong; Guengerich, 1997). The P450 enzymes are also responsible ...

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