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Titolo:
Coadministration of clozapine and fluvoxamine in psychotic patients - Clinical experience
Autore:
Lammers, CH; Deuschle, M; Weigmann, H; Hartter, S; Hiemke, C; Heese, C; Heuser, I;
Indirizzi:
Max Planck Inst Psychiat, Inst Clin, D-8000 Munich, Germany Max Planck Inst Psychiat Munich Germany D-8000 n, D-8000 Munich, Germany Univ Mainz, Dept Psychiat, D-6500 Mainz, Germany Univ Mainz Mainz Germany D-6500 nz, Dept Psychiat, D-6500 Mainz, Germany
Titolo Testata:
PHARMACOPSYCHIATRY
fascicolo: 2, volume: 32, anno: 1999,
pagine: 76 - 77
SICI:
0176-3679(199903)32:2<76:COCAFI>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
SERUM LEVELS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
10
Recensione:
Indirizzi per estratti:
Indirizzo: Deuschle, M Zent Inst Seel Gesundheit, J5, D-68159 Mannheim, Germany Zent Inst Seel Gesundheit J5 Mannheim Germany D-68159 Germany
Citazione:
C.H. Lammers et al., "Coadministration of clozapine and fluvoxamine in psychotic patients - Clinical experience", PHARMACOPS, 32(2), 1999, pp. 76-77

Abstract

Fluvoxamine (FLUVOX) is an inhibitor of the cytochrome P450 isoenzyme 1 A2and thereby inhibits clozapine (CLOZ) metabolism. We performed an open clinical study to gather experience in necessary dosages, plasma levels, side effects and clinical efficiency of the coadministration of the two drugs. Eighteen psychotic patients were studied. 50 mg FLUVOX were given throughoutthe study period, while the CLOZ dosage was increased individually (week 5: 96.9 +/- 37.2 mg). After 5 weeks the plasma concentrations were as follows: CLOZ 252 +/- 174 ng/ml, N-desmethylclozapine (DM-CLOZ) 143 +/- 74 ng/ml and clozapine N-oxide (CLOZ N-OX) 30 +/- 14 ng/ml. There were no differences in side effects, especially sedation, after 5 weeks compared to the pretreatment condition. Moreover, we found a significant improvement in measuresof cognitive speed which might be regarded as a measure of vigilance. The BPRS scores dropped continuously until week 5 (pretreatment: 53.3 +/- 13.4;week 5: 33.2 +/- 12.9) and 5 patients were considered treatment responders(BPRS reduction > 50 %). Ten patients continued the combination treatment after the study period and 9 of these patients were in clinical remission when discharged. Given strict therapeutic drug monitoring, coadministration of FLUVOX and CLOZ seems to be a safe and efficient treatment strategy witha low occurrence of the side effects associated with CLOZ treatment. This might be due to additive effects of the two drugs and/or metabolic interaction.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/01/20 alle ore 13:02:28