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Pining for Pete in the Pain Clinic

Fatal Forty DDI: nortriptyline, paroxetine, CYP2D6

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A Case Approach to Perioperative Drug-Drug Interactions

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Abstract

This case discusses the interaction of nortriptyline and paroxetine. Nortriptyline is a tricyclic antidepressant (TCA) that is a cytochrome P450 2D6 substrate and paroxetine is a 2D6 inhibitor. The interaction resulted in TCA toxicity. The metabolism of other TCAs is discussed.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, USA

    Steven S. Liu MD

  2. Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA

    Toby N. Weingarten MD

  3. Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN, USA

    Toby N. Weingarten MD & Catherine Marcucci MD

Authors
  1. Steven S. Liu MD
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  2. Toby N. Weingarten MD
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  3. Catherine Marcucci MD
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Editor information

Editors and Affiliations

  1. Anesthesia Services Department, Philadelphia Veterans Affairs Med Center, Philadelphia, PA, USA

    Catherine Marcucci MD

  2. Department of Anesthesiology, Oregon Health and Science University, Portland, OR, USA

    Michael P. Hutchens MD

  3. Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA

    Erica D. Wittwer MD, PhD , Toby N. Weingarten MD , Juraj Sprung MD, PhD  & Wayne T. Nicholson MD, PharmD, MSc , ,  & 

  4. Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

    Kirk Lalwani MD

  5. Department of Anesthesiology, University of Pittsburgh School of Med Liliane S. Kaufmann Building, Pittsburgh, PA, USA

    David G. Metro MD

  6. Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA

    Randal O. Dull MD, PhD

  7. Department of Anesthesiology, Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

    Christopher E. Swide MD

  8. Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA

    F. Jacob Seagull PhD

  9. Department of Anesthesiology and Perioperative Medicine, Portland, OR, USA

    Jeffrey R. Kirsch MD (Professor and Chair) (Professor and Chair)

  10. Department of Psychiatry, University of Maryland Medical System VA Maryland Health Care System, Baltimore, MD, USA

    Neil B. Sandson MD

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Liu, S.S., Weingarten, T.N., Marcucci, C. (2015). Pining for Pete in the Pain Clinic. In: Marcucci, C., et al. A Case Approach to Perioperative Drug-Drug Interactions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7495-1_65

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  • DOI: https://doi.org/10.1007/978-1-4614-7495-1_65

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7494-4

  • Online ISBN: 978-1-4614-7495-1

  • eBook Packages: MedicineMedicine (R0)

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