利培酮与氟西汀合并治疗精神分裂症的相互作用  

Drug interaction during combining fluoxetine and risperidone to treat schizophrenia

作　　者：张石宁[1] 姚辉[2] 李继民[3] 林红[2] 陆水平[2] 尚晓芳[2] 王筱兰[2] 孙静[2] 谭俊华[2] 韩钢[1] 

机构地区：[1]南京医科大学附属南京脑科医院神经精神病防治研究所,南京210029 [2]南京医科大学附属南京脑科医院精神科,南京210029 [3]南京医科大学附属南京脑科医院老年神经科,南京210029

出　　处：《中国临床药理学杂志》2009年第1期11-13,共3页The Chinese Journal of Clinical Pharmacology

基　　金：南京市医学科技发展基金资助项目(YKK0453)

摘　　要：目的研究利培酮(治疗精神分裂症)与氟西汀(治疗抑郁和焦虑症)合并治疗精神分裂症的相互作用。方法选取符合CCMD-3诊断标准的有合并应用氟西汀指征的精神分裂症病人29例;单用利培酮,逐渐调整剂量到每天2～6 mg,稳定1周后加用氟西汀每天20 mg,测定血浆利培酮与9-羟利培酮浓度及胰岛素、瘦素、泌乳素水平。结果在合并用药后1、2、3、4周,血浆利培酮浓度分别比合并用药前升高(4.22±3.72)、(5.00±4.28)、(4.80±3.87)、(4.83±3.30)ng·mL-1(P<0.01);血浆9-羟利培酮浓度比合并用药前降低(-0.78±3.52)、(-1.80±3.86)、(-0.86±3.88)、(-1.20±4.40)ng·mL-1(P>0.05);在合并用药4周内,胰岛素、瘦素、泌乳素水平与合并用药前无显著变化。结论决定合并用氟西汀前,应将利培酮用量适当减少;合并用药对胰岛素、瘦素、泌乳素水平较单用利培酮无显著影响。Objective To study the interaction during combining fluoxetine and risperidone in treatment of schizophrenia. Methods Twenty - nine schizophrenic patients which were diagnosed with the 3rd edition of Chinese classification and diagnostic criteria for mental disorders（ CCMD -3） and needed using anti -depressive drug were chose. Risperidone was used （2 - 6 mg · d^-1 ） , one week later the fluoxetine were given 20 mg · d^-1 to these patients this morning. Every. week the elbow vein blood 5 mL were taken to determine plasma risperidone, 9 - hydroxyrisperidone level for four weeks, at the 2nd week and the 4th week plasma insulin, leptin, prolactin level were determined. Results After combing fluoxetine and risperidone ,the plasma risperidone levels at the 1st, 2nd, 3rd, 4th week were （4.22 ± 3.72）, （5.00 ± 4.28）, （4.80 ± 3.87）, （4.83 ± 3.30） ng · mL^ - 1 significantly higher than those before combing fluoxetine（P 〈 0.01 ）. The 9 - hydroxyrisperidone level were （ - 0. 78 ± 3.52 ） , （ 1.80 ±3.86）, （ - 0.86 ±3.88 ）, （ - 1.20 ± 4.40） ng · mL^- 1 hadn＇ t significantly distinction. The insulin, leptin, prolactin level were hadn＇ t significantly distinction before and after combining fluoxetine and risperidone. Conclusion It suggest that to adjust risperidone quantity following the plasma risperidone, 9 -hydroxyrisperidone level and patients clinic symptoms. The insulin, leptin, prolactin level hadn＇t significantly distinction before and aftereombining fluoxetine and risperidone.

关 键 词：利培酮 氟西汀 精神分裂症 药物相互作用 

分 类 号：R971.41[医药卫生—药品] R749.3[医药卫生—药学]