Fluctuation between cigarette smoking and use of electronic nicotine delivery systems: Impact on clozapine concentrations and clinical effect
Unlike with smoking cigarettes, electronic nicotine delivery systems do not cause CYP450 1A2 induction as there is a lack of combustion and polycyclic aromatic hydrocarbon production. Changing to the use of an electronic nicotine delivery system from cigarettes can result in the deinduction of CYP45...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
American Association of Psychiatric Pharmacists
2021-11-01
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| Series: | Mental Health Clinician |
| Subjects: | |
| Online Access: | https://theijpt.org/doi/pdf/10.9740/mhc.2021.11.365 |
| _version_ | 1797383423276351488 |
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| author | Montville Daniel J. MD Lindsey Jaclyn M. MD Leung Jonathan G. PharmD |
| author_facet | Montville Daniel J. MD Lindsey Jaclyn M. MD Leung Jonathan G. PharmD |
| author_sort | Montville Daniel J. MD |
| collection | DOAJ |
| description | Unlike with smoking cigarettes, electronic nicotine delivery systems do not cause CYP450 1A2 induction as there is a lack of combustion and polycyclic aromatic hydrocarbon production. Changing to the use of an electronic nicotine delivery system from cigarettes can result in the deinduction of CYP450 1A2 and the increase of certain medication serum concentrations, including clozapine. A case is reported in which the switch from smoking to an electronic nicotine delivery system resulted in increased clozapine serum concentration and constipation, necessitating pharmacologic management. The patient ultimately transitioned back to cigarettes, which resulted in the emergence of psychiatric symptoms. An evaluation of longitudinal serum concentrations and clinical correlation is provided. It is important that patients and health care professionals have knowledge not only about the impact of smoking cigarettes on clozapine metabolism, but also the effects of switching to or from an electronic nicotine delivery system. |
| first_indexed | 2024-03-08T21:20:44Z |
| format | Article |
| id | doaj.art-e52b1ccc94b742bb85df13e5d8c4152f |
| institution | Directory Open Access Journal |
| issn | 2168-9709 |
| language | English |
| last_indexed | 2024-03-08T21:20:44Z |
| publishDate | 2021-11-01 |
| publisher | American Association of Psychiatric Pharmacists |
| record_format | Article |
| series | Mental Health Clinician |
| spelling | doaj.art-e52b1ccc94b742bb85df13e5d8c4152f2023-12-21T11:44:37ZengAmerican Association of Psychiatric PharmacistsMental Health Clinician2168-97092021-11-0111636536810.9740/mhc.2021.11.365i2168-9709-11-6-365Fluctuation between cigarette smoking and use of electronic nicotine delivery systems: Impact on clozapine concentrations and clinical effectMontville Daniel J. MD0https://orcid.org/0000-0001-6487-440XLindsey Jaclyn M. MD1https://orcid.org/0000-0002-3940-1392Leung Jonathan G. PharmD2https://orcid.org/0000-0003-3836-93751 Psychiatry Resident, Mayo Clinic, Rochester, Minnesota2 Psychiatry Resident, Mayo Clinic, Rochester, Minnesota3 Psychiatric Clinical Pharmacist, Mayo Clinic, Rochester, MinnesotaUnlike with smoking cigarettes, electronic nicotine delivery systems do not cause CYP450 1A2 induction as there is a lack of combustion and polycyclic aromatic hydrocarbon production. Changing to the use of an electronic nicotine delivery system from cigarettes can result in the deinduction of CYP450 1A2 and the increase of certain medication serum concentrations, including clozapine. A case is reported in which the switch from smoking to an electronic nicotine delivery system resulted in increased clozapine serum concentration and constipation, necessitating pharmacologic management. The patient ultimately transitioned back to cigarettes, which resulted in the emergence of psychiatric symptoms. An evaluation of longitudinal serum concentrations and clinical correlation is provided. It is important that patients and health care professionals have knowledge not only about the impact of smoking cigarettes on clozapine metabolism, but also the effects of switching to or from an electronic nicotine delivery system.https://theijpt.org/doi/pdf/10.9740/mhc.2021.11.365smokingcigarettesnicotineelectronic nicotine delivery systemscyp450 1a2drug interactionclozapine |
| spellingShingle | Montville Daniel J. MD Lindsey Jaclyn M. MD Leung Jonathan G. PharmD Fluctuation between cigarette smoking and use of electronic nicotine delivery systems: Impact on clozapine concentrations and clinical effect Mental Health Clinician smoking cigarettes nicotine electronic nicotine delivery systems cyp450 1a2 drug interaction clozapine |
| title | Fluctuation between cigarette smoking and use of electronic nicotine delivery systems: Impact on clozapine concentrations and clinical effect |
| title_full | Fluctuation between cigarette smoking and use of electronic nicotine delivery systems: Impact on clozapine concentrations and clinical effect |
| title_fullStr | Fluctuation between cigarette smoking and use of electronic nicotine delivery systems: Impact on clozapine concentrations and clinical effect |
| title_full_unstemmed | Fluctuation between cigarette smoking and use of electronic nicotine delivery systems: Impact on clozapine concentrations and clinical effect |
| title_short | Fluctuation between cigarette smoking and use of electronic nicotine delivery systems: Impact on clozapine concentrations and clinical effect |
| title_sort | fluctuation between cigarette smoking and use of electronic nicotine delivery systems impact on clozapine concentrations and clinical effect |
| topic | smoking cigarettes nicotine electronic nicotine delivery systems cyp450 1a2 drug interaction clozapine |
| url | https://theijpt.org/doi/pdf/10.9740/mhc.2021.11.365 |
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