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Differential Effects of Fluvoxamine and Other Antidepressants on the Biotransformation of Melatonin

Härtter, Sebastian PhD*; Wang, Ximing MD; Weigmann, Harald MD*; Friedberg, Thomas PhD§; Arand, Michael PhD; Oesch, Franz PhD; Hiemke, Christoph PhD*

Journal of Clinical Psychopharmacology: April 2001 - Volume 21 - Issue 2 - p 167-174
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Melatonin, the predominant product of the pineal gland, is involved in the maintenance of diurnal. rhythms. Nocturnal blood concentrations of melatonin have been shown to be enhanced by fluvoxamine, but not by other serotonin reuptake inhibitors. Because fluvoxamine is an inhibitor of several cytochrome P450 (CYP) enzymes, the authors studied the biotransformation of melatonin and the effects of fluvoxamine on the metabolism of melatonin in vitro using human liver microsomes and recombinant human CYP isoenzymes. Melatonin was found to be almost exclusively metabolized by CYP1A2 to 6-hydroxymelatonin and N-acetylserotonin with a minimal contribution of CYP2C19. Both reactions were potently inhibited by fluvoxamine, with a Ki of 0.02 μM for the formation of 6-hydroxymelatonin and 0.05 μM for the formation of N-acetylserotonin. Other than fluvoxamine, fluoxetine, paroxetine, citalopram, imipramine and desipramine were also tested at 2 and 20 μM. Among the other antidepressants, only paroxetine was able to affect the metabolism of melatonin at supratherapeutic concentrations of 20 μM, which did not reach by far the magnitude of the inhibitory potency of fluvoxamine. The authors concluded that fluvoxamine is a potent inhibitor of melatonin degradation. Because this inhibitory action is also found in vivo, fluvoxamine might be used as an enhancer of melatonin, which might offer new therapeutic possibilities of fluvoxamine.

*Departments of Psychiatry and †Toxicology, University of Mainz, Mainz, Germany; ‡Tongji Medical University, Wuhan, People's Republic of China; §Biomedical Research Center, Ninewells Hospital and Medical School, Dundee, Scotland

Received February 2, 2000; accepted after revision July 20, 2000.

Address requests for reprints to: Christoph Hiemke, PhD, Department of Psychiatry, University of Mainz, Untere Zahlbachertraße 8, 55131-Mainz, Germany. Address e-mail to: hiemke@mail.uni-mainz.de.

© 2001 Lippincott Williams & Wilkins, Inc.