Psychiatry Investig.  2012 Dec;9(4):422-424.

Prolonged Drug-Drug Interaction between Terbinafine and Perphenazine

• Park YM

Abstract

I report here an elderly woman receiving perphenazine together with terbinafine. After 1 week of terbinafine treatment she experienced extrapyramidal symptoms and, in particular, akathisia. Her symptoms did not disappear for 6 weeks, and so at 2 weeks prior to this most recent admission she had stopped taking terbinafine. However, these symptoms persisted for 3 weeks after discontinuing terbinafine. It is well known that terbinafine inhibits CYP2D6 and that perphenazine is metabolized mainly by CYP2D6. Thus, when terbinafine and perphenazine are coadministrated, the subsequent increase in the concentration of perphenazine may induce extrapyramidal symptoms. Thus, terbinafine therapy may be associated with the induction and persistence of extrapyramidal symptoms, including akathisia. This case report emphasizes the importance of monitoring drug-drug interactions in patients undergoing terbinafine and perphenazine therapy.

Keyword

Terbinafine; Perphenazine; Drug-drug interaction; Akathisia; Extrapyramidal symptoms

MeSH Terms

Aged
Cytochrome P-450 CYP2D6
Female
Humans
Naphthalenes
Perphenazine
Psychomotor Agitation
Cytochrome P-450 CYP2D6
Naphthalenes
Perphenazine