Kennedy N B, Procyshyn R M
University of British Columbia, Vancouver, Canada.
Can J Clin Pharmacol. 2000 Autumn;7(3):155-9.
The use of two antipsychotics for the treatment of individuals with psychiatric disorders is not uncommon in clinical practice but is rarely documented in the literature. The present article suggests an alternative method of treating individuals who show a partial but inadequate response to antipsychotic monotherapy. A rational strategy for augmenting one antipsychotic with a second, based on pharmacodynamic and pharmacokinetic principles, is provided. The present approach considers the 5-hydroxytryptamine2 to dopamine2 ratio, other complementary receptor affinities and drug-drug interactions involving the cytochrome P450 isoenzymes. The present article presents a rationale for augmenting haloperidol in patients who are partially responsive to clozapine.
在临床实践中，使用两种抗精神病药物治疗精神疾病患者的情况并不少见，但在文献中却鲜有记载。本文提出了一种替代方法，用于治疗对抗精神病药物单一疗法有部分但不充分反应的患者。基于药效学和药代动力学原理，提供了一种用第二种抗精神病药物增强第一种药物疗效的合理策略。目前的方法考虑了5-羟色胺2与多巴胺2的比例、其他互补的受体亲和力以及涉及细胞色素P450同工酶的药物相互作用。本文阐述了在对氯氮平部分反应的患者中增强氟哌啶醇疗效的理论依据。
