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Titolo:
Addition of low-dose fluvoxamine to low-dose clozapine monotherapy in schizophrenia: Drug monitoring and tolerability data from a prospective clinical trial
Autore:
Szegedi, A; Anghelescu, I; Wiesner, J; Schlegel, S; Weigmann, H; Hartter, S; Hiemke, C; Wetzel, H;
Indirizzi:
Univ Mainz, Psychiat Klin, Dept Psychiat, D-55131 Mainz, Germany Univ Mainz Mainz Germany D-55131 , Dept Psychiat, D-55131 Mainz, Germany
Titolo Testata:
PHARMACOPSYCHIATRY
fascicolo: 4, volume: 32, anno: 1999,
pagine: 148 - 153
SICI:
0176-3679(199907)32:4<148:AOLFTL>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
SEROTONIN REUPTAKE INHIBITORS; SERUM LEVELS; DOUBLE-BLIND; RESISTANT SCHIZOPHRENIA; NEGATIVE SYMPTOMS; METABOLITES; SEIZURES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Szegedi, A Univ Mainz, Psychiat Klin, Dept Psychiat, Untere Zahlbacherstr 8, D-55131 Mainz, Germany Univ Mainz Untere Zahlbacherstr 8 Mainz Germany D-55131 ermany
Citazione:
A. Szegedi et al., "Addition of low-dose fluvoxamine to low-dose clozapine monotherapy in schizophrenia: Drug monitoring and tolerability data from a prospective clinical trial", PHARMACOPS, 32(4), 1999, pp. 148-153

Abstract

Combining fluvoxamine and clozapine may be a strategy to improve therapeutic effects on negative symptoms in schizophrenic patients. Fluvoxamine, however, markedly inhibits the metabolism of clozapine, and hazardous side effects may result. This study prospectively investigated the safety and tolerability of an add-on therapy with fluvoxamine to a clozapine monotherapy inschizophrenic patients. Sixteen schizophrenic patients received 50 mg fluvoxamine as a comedication after having reached steady-state conditions under clozapine monotherapy. Patients were monitored for subjective adverse events, laboratory parameters, EEC and ECG recordings, orthostatic hypotensionand their psychopathology. Concomitantly, serum concentrations of clozapine and metabolites were measured during monotherapy and after addition of fluvoxamine. In all patients, the serum concentrations of clozapine and metabolites were markedly increased (average: 2-3 fold, up to 5 fold for clozapine) after addition of fluvoxamine. Side effects remained almost unchanged in frequency and severity in spite of the pharmacokinetic interactions. ECG or laboratory parameters and orthostatic tests were similar under monotherapy and comedication. Minimal increases of EEG abnormalities were observed, but they were not associated with clinical impairment. Epileptic activitieswere always absent. The psychopathology improved which continued after start of the comedication. Though the addition of fluvoxamine to clozapine medication was well tolerated and critical side effects were absent, the combined treatment should be controlled by drug monitoring, as serum concentrations of clozapine increased to unpredictably high levels. Further studies have to find out if the combined treatment could be advantageous to clozapinemonotherapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 14:34:21