Serum levels of clozapine and norclozapine in patients treated with selective serotonin reuptake inhibitors.
Serum levels of clozapine and norclozapine in patients treated with selective serotonin reuptake inhibitors.
复制标题
用选择性血清素再摄取抑制剂治疗的患者中氯氮平和去甲氯氮平的血清水平。
DOI：
10.1176/ajp.153.6.820
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
Flood,JG
中科院分区：
文献类型：
--
作者：
Centorrino,F;Baldessarini,RJ;Frankenburg,FR;Kando,J;Volpicelli,SA;Flood,JG
目的选择性5-羟色胺再摄取抑制剂（SSRI）氟西汀可升高氯氮平和去甲氯氮平的血清水平，但其他SSRIs的影响尚不清楚。因此，作者评估了氯氮平与氟西汀、帕罗西汀和舍曲林的相互作用。方法对 80 名精神病患者的血清氯氮平和去甲氯氮平浓度进行了测定，这些患者的年龄和氯氮平剂量相匹配，单独给予氯氮平（平均剂量 = 279 毫克/天）或与氟西汀（平均剂量 = 39.3 毫克/天）、帕罗西汀（平均值 = 31.2毫克/天）或舍曲林（平均值 = 92.5 毫克/天）。每位患者的氯氮平剂量在血清采样前至少一个月保持稳定。结果服用 SSRI 的患者中，氯氮平加去甲氯氮平的浓度平均高出 43%，浓度高于 1000 ng/ml 的风险高出 10 倍 (25%)，服用个别 SSRI 的患者之间存在微小差异。 结论
ObjectiveThe selective serotonin reuptake inhibitor (SSRI) fluoxetine can increase serum levels of clozapine and norclozapine, but effects of other SSRIs are unknown. Thus, the authors evaluated interactions of clozapine with fluoxetine, paroxetine, and sertraline.MethodSerum clozapine and norclozapine concentrations were assayed in 80 psychiatric patients, matched for age and clozapine dose, given clozapine (mean dose= 279 mg/day) alone or with fluoxetine (mean dose= 39.3 mg/day), paroxetine (mean= 31.2 mg/day), or sertraline (mean= 92.5 mg/day). Each patient's dose of clozapine was stable for at least a month before serum sampling.ResultsConcentrations of clozapine plus norclozapine averaged 43% higher, and the risk of levels higher than 1000 ng/ml was 10-fold greater (25%), in the patients taking SSRIs, with minor differences between patients taking the individual SSRIs.Conclusions