Bertschy G, Baumann P, Eap C B, Baettig D
Département Universitaire de Psychiatrie Adulte, Lausanne, Switzerland.
Ther Drug Monit. 1994 Feb;16(1):42-5. doi: 10.1097/00007691-199402000-00006.
We report five cases where fluvoxamine (FLVX) was added to maintenance treatment with methadone (MTD) in addict patients with affective disorders. In view of the implication of FLVX in several metabolic drug interactions, MTD plasma levels were measured before and after treatment with FLVX. A slight increase (approximately 20% of the MTD plasma level/dose ratio) occurred in two cases. In the remaining three patients, the interaction was more pronounced (40-100% increase of the MTD plasma level/dose ratio), with clinical manifestations of opiate withdrawal after stopping FLVX therapy in one case. Caution is needed when starting or stopping treatment with FLVX in patients receiving maintenance treatment with methadone.
我们报告了5例在患有情感障碍的成瘾患者中，在美沙酮维持治疗的基础上加用氟伏沙明（FLVX）的病例。鉴于FLVX存在多种代谢性药物相互作用，在使用FLVX治疗前后测量了美沙酮（MTD）的血浆水平。2例出现轻微升高（约为MTD血浆水平/剂量比的20%）。在其余3例患者中，相互作用更为明显（MTD血浆水平/剂量比升高40 - 100%），其中1例在停用FLVX治疗后出现阿片类药物戒断的临床表现。在接受美沙酮维持治疗的患者中开始或停止使用FLVX治疗时需要谨慎。
