Lee M S, Han C S, You Y W, Kim S H
Department of Psychiatry, College of Medicine, Korea University, Seoul.
Psychiatry Clin Neurosci. 1998 Dec;52 Suppl:S193-8. doi: 10.1111/j.1440-1819.1998.tb03220.x.
Along with recent increased interest in the selective serotonin reuptake inhibitors, a number of studies has been undertaken to observe interactions with different drugs. When selective serotonin reuptake inhibitor was administered together with antipsychotics to schizophrenics showing depressive or obsessive symptoms and negative symptoms, meaningful results were observed. The objective of our research was to identify the changes in the concentration of plasma haloperidol when sertraline was administered to patients who already were being treated with haloperidol. Sixteen patients who did not respond to the traditional antipsychotics after 2 weeks of treatment with a certain dosage of haloperidol were administered with 50 mg of sertraline for a period of 2 weeks. The concentration changes between plasma haloperidol and the reduced haloperidol were observed using high-powered liquid chromatography equipped with a UV detector. There was a significant increase (P < 0.01) in the concentration of haloperidol, the change being from 8.52 +/- 4.22 to 10.91 +/- 5.38 ng/mL. However, the change in the concentration of reduced haloperidol was from 7.41 +/- 7.93 to 5.22 +/- 6.10 ng/mL, showing a significant decrease. The concentrations of total plasma haloperidol showed no significant changes at all. In comparing the ratio of the reduced haloperidol and the haloperidol, the reduction ratio was down to 0.39 +/- 0.27 from 0.94 +/- 0.65 showing a significant decrease. There seems to be few studies done on interactions using serotonergic drugs together with antipsychotics in spite of their clinically applicable possibility. According to similar studies done in the past, co-administering of such drugs not only increases the plasma concentration of antipsychotics, but it also results in clinical improvement of negative symptoms and aggravation of extrapyramidal symptoms. Changes in clinical symptoms and adverse effects were not observed in our study. However, we think these observations need to be included in upcoming larger scale studies.
随着近期对选择性5-羟色胺再摄取抑制剂的兴趣增加,已经开展了多项研究来观察其与不同药物的相互作用。当将选择性5-羟色胺再摄取抑制剂与抗精神病药物一起给予表现出抑郁或强迫症状以及阴性症状的精神分裂症患者时,观察到了有意义的结果。我们研究的目的是确定在已经接受氟哌啶醇治疗的患者中给予舍曲林后血浆氟哌啶醇浓度的变化。16例在接受一定剂量氟哌啶醇治疗2周后对传统抗精神病药物无反应的患者,给予50mg舍曲林,为期2周。使用配备紫外检测器的高效液相色谱法观察血浆氟哌啶醇和去甲氟哌啶醇浓度的变化。氟哌啶醇浓度有显著升高(P<0.01),从8.52±4.22ng/mL变为10.91±5.38ng/mL。然而,去甲氟哌啶醇浓度从7.41±7.93ng/mL变为5.22±6.10ng/mL,呈现显著下降。血浆总氟哌啶醇浓度根本没有显著变化。在比较去甲氟哌啶醇与氟哌啶醇的比例时,降低比例从0.94±0.65降至0.39±0.27,呈现显著下降。尽管5-羟色胺能药物与抗精神病药物联合使用具有临床应用可能性,但关于它们相互作用的研究似乎很少。根据过去进行的类似研究,同时给予这类药物不仅会增加抗精神病药物的血浆浓度,还会导致阴性症状的临床改善和锥体外系症状的加重。在我们的研究中未观察到临床症状和不良反应的变化。然而,我们认为这些观察结果需要纳入即将开展的更大规模研究中。