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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 investigate the interaction of risperidone (for the treatment of schizophrenia) and fluoxetine (for the treatment of depression and anxiety) in the treatment of schizophrenia. Methods A total of 29 schizophrenic patients with combined use of fluoxetine indications and CCRD-3 criteria were selected. Risperidone alone was used to adjust the dose gradually to 2 ~ 6 mg per day. After stable for 1 week, fluoxetine Daily 20 mg, determination of plasma risperidone and 9-hydroxy risperidone concentration and insulin, leptin, prolactin levels. Results The plasma risperidone concentrations were significantly increased (4.22 ± 3.72), (5.00 ± 4.28), (4.80 ± 3.87), (4.83 ± 3.30) ng (-1.88 ± 3.52), (-1.88 ± 3.86), (-1.86 ± 3.88), (-1.20 ± 4.40), respectively. The plasma concentration of 9-hydroxy- ng · mL-1 (P> 0.05). There was no significant change in insulin, leptin and prolactin levels within 4 weeks after the combination therapy with the combination therapy. Conclusions Before deciding to combine fluoxetine, the dosage of risperidone should be appropriately reduced. The combination therapy has no significant effect on the levels of insulin, leptin and prolactin compared with risperidone alone.