“To See Nice Things (grow)”
10% of individuals are 2C19 ultrarapid metabolizers. 5% are poor metabolizers.
Conclusion: 2C19 genotyping is not typically ordered as a standalone test, but if 2C19 metabolizer genotype is known (e.g., from GeneSight or Genecept), the information can be put to good use when dosing (es)citalopram and sertraline. Knowledge of metabolizer status is not essential because these SSRIs can be titrated
2C19 Poor Metabolizers
Individuals with a 2C19 PM genotype clear 2C19 substrates slowly, leading to Higher blood levels (as if they were taking a 2C19 inHibitor). Standard doses of 2C19 substrates may be too strong.
5% of population (20% of Asians) are 2C19 PMs.
*2C19 poor metabolizers should not exceed 20 mg of citalopram (QT prolongation).
2C19 Ultrarapid Metabolizers
2C19 UM individuals clear 2C19 substrates quickly, leading to low blood levels. These individuals are more likely to be non-responders to 2C19 substrates at standard doses.