{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T16:08:05Z","timestamp":1759939685119,"version":"3.37.3"},"reference-count":8,"publisher":"American Association of Psychiatric Pharmacists (AAPP)","issue":"4","license":[{"start":{"date-parts":[[2019,9,24]],"date-time":"2019-09-24T00:00:00Z","timestamp":1569283200000},"content-version":"vor","delay-in-days":450,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>To describe a patient case in which a drug interaction involving quetiapine and phenytoin resulted in an absence of clinical response and serum quetiapine levels below the point of detection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case Summary:<\/jats:title>\n                  <jats:p>This patient was on concurrent phenytoin, valproic acid, and quetiapine therapy for 10 months. Prior to discontinuing phenytoin, a serum quetiapine level was found to be less than 10 ng\/mL. It took approximately 1 month after phenytoin's discontinuation for quetiapine levels to attain measurable concentrations. The patient's clinical response to quetiapine improved significantly after this interaction resolved.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion:<\/jats:title>\n                  <jats:p>Phenytoin is an inducer of cytochrome P450 3A4, and quetiapine is a substrate of this enzyme. Patients on concurrent phenytoin and quetiapine therapy may require monitoring of quetiapine concentrations, which is often not routine practice, as this drug interaction can result in a clinically significant reduction in quetiapine levels contributing to a lack of efficacy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.9740\/mhc.2018.07.195","type":"journal-article","created":{"date-parts":[[2018,7,6]],"date-time":"2018-07-06T18:49:32Z","timestamp":1530902972000},"page":"195-197","source":"Crossref","is-referenced-by-count":2,"title":["Important drug interaction involving phenytoin and quetiapine"],"prefix":"10.9740","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8632-0974","authenticated-orcid":false,"given":"Michele","family":"Thomas","sequence":"first","affiliation":[{"name":"(Corresponding author) Assistant Director of Pharmacy, Springfield Hospital Center, University of Maryland School of Pharmacy Baltimore, Sykesville, Maryland, michele.thomas@maryland.gov"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6284-8010","authenticated-orcid":false,"given":"Bethany A.","family":"DiPaula","sequence":"additional","affiliation":[{"name":"Associate Professor, University of Maryland School of Pharmacy Baltimore, Baltimore, Maryland; Director of Pharmacy, Springfield Hospital Center, Sykesville, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4191-0281","authenticated-orcid":false,"given":"Beverley","family":"Grimm","sequence":"additional","affiliation":[{"name":"Unit Director, Springfield Hospital Center, Sykesville, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4719","reference":[{"issue":"3","key":"2020060307274580700_i2168-9709-8-4-195-b01","doi-asserted-by":"publisher","first-page":"254","DOI":"10.2174\/157015910792246254","article-title":"Antiepileptic drug interactions \u2013 Principles and clinical implications","volume":"8","author":"Johannessen","year":"2010","journal-title":"Curr Neuropharmacol"},{"year":"2005","key":"2020060307274580700_i2168-9709-8-4-195-b02","article-title":"LABEL: SEROQUEL- quetiapine fumarate tablet, film coated [Internet]"},{"issue":"1","key":"2020060307274580700_i2168-9709-8-4-195-b03","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1097\/WNF.0b013e31816a1cc6","article-title":"Drug interaction can lead to undetectable serum concentrations of quetiapine in the presence of carbamazepine","volume":"32","author":"Nickl-Jockschat","year":"2009","journal-title":"Clin Neuropharmacol"},{"year":"2005","key":"2020060307274580700_i2168-9709-8-4-195-b04","article-title":"LABEL: DILANTIN phenytoin sodium capsule, extended release [Internet]"},{"key":"2020060307274580700_i2168-9709-8-4-195-b05","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.phrs.2016.02.014","article-title":"Clinically significant pharmacokinetic drug interactions of antiepileptic drugs with new antidepressants and new antipsychotics","volume":"106","author":"Spina","year":"2016","journal-title":"Pharmacol Res"},{"issue":"1","key":"2020060307274580700_i2168-9709-8-4-195-b06","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1097\/00004714-200102000-00016","article-title":"The effects of concomitant phenytoin administration on the steady-state pharmacokinetics of quetiapine","volume":"21","author":"Wong","year":"2001","journal-title":"J Clin Psychopharmacol"},{"issue":"3","key":"2020060307274580700_i2168-9709-8-4-195-b07","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1176\/appi.psy.44.3.255","article-title":"Six patterns of drug-drug interactions","volume":"44","author":"Armstrong","year":"2003","journal-title":"Psychosomatics"},{"issue":"4","key":"2020060307274580700_i2168-9709-8-4-195-b08","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/00007691-198512000-00004","article-title":"Serum concentrations of valproic acid: Influence of dose and comedication","volume":"7","author":"May","year":"1985","journal-title":"Ther Drug Monit"}],"container-title":["Mental Health Clinician"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/mhc\/article-pdf\/8\/4\/195\/2095116\/mhc_2018_07_195.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/mhc\/article-pdf\/8\/4\/195\/2095116\/mhc_2018_07_195.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T16:20:25Z","timestamp":1731687625000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhc.kglmeridian.com\/view\/journals\/mhcl\/8\/4\/article-p195.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,1]]},"references-count":8,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,7,1]]}},"URL":"https:\/\/doi.org\/10.9740\/mhc.2018.07.195","relation":{},"ISSN":["2168-9709"],"issn-type":[{"type":"electronic","value":"2168-9709"}],"subject":[],"published":{"date-parts":[[2018,7,1]]}}}