Table 6.

CYP2C19 phenotypes and the therapeutic recommendations for imipramine therapy, from The Dutch Pharmacogenetics Working Group (2011)

PhenotypeRecommendations for imipramine therapy
Ultrarapid metabolizerNo dose recommendations
Intermediate metabolizerNo dose recommendations
Poor metabolizerReduce dose by 70% and monitor plasma concentration of imipramine and desipramine or select alternative drug (e.g., fluvoxamine, mirtazapine)

The level of evidence for the therapeutic (dose) recommendations is 4/4 (“good quality”) for all metabolizer types. The table is adapted from (31)

From: Imipramine Therapy and CYP2D6 and CYP2C19 Genotype

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