mCPP
trazodone/nefazodone metabolite
“M.C. Poor Puppy”
mCPP = Meta-chlorophenylpiperazine
Active metabolite of trazodone and nefazodone
May cause dysphoria, anxiety, and hallucinations at higher levels
What it ismeta-chlorophenylpiperazine, a metabolite shared by trazodone and nefazodone, a 5-HT2C agonist.
Why it mattersIt is anxiogenic and can cause the agitation and dysphoria occasionally seen early in trazodone treatment.
What it changesIts accumulation in CYP2D6 poor metabolizers explains why some patients tolerate trazodone poorly at any dose.
NO BOXED WARNINGS
Principal riskLittle in its own right; see the parent drug