First phase of antipsychotic metabolism in the liver: the role of oxidation

Abstract

This article discusses issues related to the role of biotransformation or metabolism of antipsychotics (APs) in the liver. There are three phases of APs metabolism. Cytochrome P450 monooxygenase, an oxidase with mixed functions, plays a key role in the biotransformation of most APs, participating in the first phase of metabolism. The functional activity of cytochrome P450 enzymes depends on the carriage of single nucleotide variants (SNVs) of the genes encoding these enzymes, as well as on drug-drug interactions. The functional activity of cytochrome P450 enzymes may affect the efficacy and safety of the use of APs. It is important for a practicing psychiatrist to know the pathways of APs oxidation to prevent adverse drug reactions (ADRs) and unwanted drug-drug interactions, which will subsequently increase the efficacy and safety of AP therapy