Glossopharyngeal Dystonia Secondary to a Lurasidone-Fluoxetine CYP-3A4 Interaction

Table 1

CYP 3A4 substrates, inhibitors, and inducers.

CYP enzyme	Substrates	Inhibitors^a	Inducers
3A4	Alprazolam, amiodarone, amitriptyline, ^bastemizole, bupropion, caffeine, ^bcarbamazepine, cisapride, clarithromycin, clonazepam, codeine, ^bcortisol, cyclosporin, dapsone, ^bdesmethyldiazepam, ^bdiazepam, ^bdiltiazem, erythromycin, estradiol, ethinylestradiol, fluoxetine, haloperidol, ^bimipramine, ^blidocaine, loratadine, lovastatin, midazolam, nefazodone, nicardipine, nifedipine, omeprazole, ^bondansetron, orphenadrine, progesterone, quinidine, rifampin, sertraline, tamoxifen, terfenadine, testosterone, trazodone, triazolam, venlafaxine, ^bverapamil, and ^bzolpidem	Cimetidine, erythromycin, fluoxetine, fluvoxamine, indinavir, ketoconazole, naringenin, nefazodone, ritonavir, saquinavir, and sertraline (weak)	Barbiturates, carbamazepine, dexamethasone, phenytoin, rifampin, and St. John's wort

aInhibitory potency varies greatly. ^bMore than one CYP enzyme is known to be involved in the metabolism of these drugs.⁵
Reprinted with permission from the American Psychiatric Publishing Textbook of Psychopharmacology (Copyright 2009), American Psychiatric Association.⁶