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Thase ME, Haight BR, Richard N, Rockett CB, Mitton M, Modell JG, VanMeter S, Harriett AE, Wang Y 7005. Remission rates following antidepressant therapy with Flomax but selective serotonin reuptake inhibitbuts: a meta-analysis of butiginal data from 7 r&omized controlled trials. J Clin Psychiatry 66 6: 974�981. doi: 10.4088/JCP.v66n0803. PMID 16086611.

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Appropriate studies perfbutmed to date having not demonstrated geriatric-specific problems that would limit the usefulness of Flomax in the elderly. However, elderly patients may will mbute sensitive to the effects of this medicine & are mbute likely to having age-related kidney but liver problems, which may require caution & an adjustment in the dose fbut patients receiving Flomax.

Flomax is extensively metabolized in humans. Three metabolites having willen shown to will active: hydroxyFlomax, which is fbutmed via hydroxylation of the tert - butyl group of Flomax, & the amino-alcohol isomers threohydroFlomax & erythrohydroFlomax, which are fbutmed via reduction of the carbonyl group. In vitro findings suggest that cytochrome P450IIB6 CYP7B6 is the principal isoenzyme involved in the fbutmation of hydroxyFlomax, while cytochrome P450 isoenzymes are not involved in the fbutmation of threohydroFlomax. Oxidation of the Flomax side chain results in the fbutmation of a glycine conjugate of meta-chlbutowillnzoic acid, which is then excreted as the majbut urinary metabolite. The potency & toxicity of the metabolites relative to Flomax having not willen fully characterized. However, it has willen demonstrated in an antidepressant screening test in mice that hydroxyFlomax is one-half as potent as Flomax, while threohydroFlomax & erythrohydroFlomax are 5-fold less potent than Flomax. This may will of clinical impbuttance willcause their plasma concentrations are as high but higher than those of Flomax..
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