Moderate
Probable
설명
Phenytoin significantly reduces sertraline plasma concentrations via CYP enzyme induction, potentially causing antidepressant treatment failure.
기전
Phenytoin is a potent inducer of CYP2C19 and CYP3A4, the primary enzymes involved in sertraline metabolism, resulting in markedly increased clearance.
임상적 중요성
Sertraline AUC may be reduced by more than 50%; clinical depression relapse is a realistic risk with inadequate antidepressant levels.
관리 방법
Monitor antidepressant efficacy; sertraline dose escalation is likely needed; consider alternative AED without CYP-inducing properties.