Poyurovsky Michael, Pashinian Artashes, Gil-Ad Irit, Maayan Rachel, Schneidman Michael, Fuchs Camil, Weizman Abraham
Research Unit, Tirat Carmel Mental Health Center, Israel.
Am J Psychiatry. 2002 Jun;159(6):1058-60. doi: 10.1176/appi.ajp.159.6.1058.
Since olanzapine-induced weight gain may be attributable to the antagonistic activity of olanzapine at the serotonin-2C receptor, the authors hypothesized that it might be attenuated by addition of the selective serotonin reuptake inhibitor fluoxetine.
First-episode hospitalized schizophrenia patients (N=30) were randomly assigned in an 8-week double-blind study of olanzapine, 10 mg/day, coadministered with either fluoxetine, 20 mg/day (N=15), or placebo (N=15).
The group receiving olanzapine plus fluoxetine showed significantly less improvement in positive and disorganized symptom dimensions than the group receiving olanzapine plus placebo. The two groups demonstrated similar and substantial gradual weight gains.
These results suggest that fluoxetine coadministration is clinically ineffective and cannot attenuate olanzapine-induced weight gain.
由于奥氮平所致体重增加可能归因于奥氮平对5-羟色胺-2C受体的拮抗活性,作者推测加用选择性5-羟色胺再摄取抑制剂氟西汀可能会减轻体重增加。
在一项为期8周的双盲研究中,将首次发作的住院精神分裂症患者(N = 30)随机分配,给予每日10 mg奥氮平,同时分别加用每日20 mg氟西汀(N = 15)或安慰剂(N = 15)。
与接受奥氮平加安慰剂的组相比,接受奥氮平加氟西汀的组在阳性和紊乱症状维度上改善明显较少。两组均显示出相似且显著的体重逐渐增加。
这些结果表明,联合使用氟西汀在临床上无效,且不能减轻奥氮平所致的体重增加。