Coadministration of clozapine and fluvoxamine in psychotic patients--clinical experience.

摘要: Fluvoxamine (FLUVOX) is an inhibitor of the cytochrome P450 isoenzyme 1 A2 and thereby inhibits clozapine (CLOZ) metabolism. We performed open clinical study to gather experience in necessary dosages, plasma levels, side effects efficiency coadministration two drugs. Eighteen psychotic patients were studied. 50 mg FLUVOX given throughout period, while CLOZ dosage was increased individually (week 5: 96.9+/-37.2 mg). After 5 weeks concentrations as follows: 252+/-174 ng/ml, N-desmethylclozapine (DM-CLOZ) 143+/-74 ng/ml N-oxide (CLOZ N-OX) 30+/-14 ng/ml. There no differences effects, especially sedation, after compared pretreatment condition. Moreover, we found a significant improvement measures cognitive speed which might be regarded measure vigilance. The BPRS scores dropped continuously until week (pretreatment: 53.3+/-13.4; 33.2+/-12.9) considered treatment responders (BPRS reduction > 50%). Ten continued combination period 9 these remission when discharged. Given strict therapeutic drug monitoring, seems safe efficient strategy with low occurrence associated treatment. This due additive drugs and/or metabolic interaction.