Serum levels of clozapine and norclozapine in patients treated with selective serotonin reuptake inhibitors
OBJECTIVE: The selective serotonin reuptake inhibitor (SSRI) fluoxetine can increase serum levels of clozapine and norclozapine, but effects of other SSRIs are unknown. Thus, the authors evaluated interactions of clozapine with fluoxetine, paroxetine, and sertraline. METHOD: Serum clozapine and norc...
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| Veröffentlicht in: | The American journal of psychiatry 1996-06, Vol.153 (6), p.820-822 |
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| container_title | The American journal of psychiatry |
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| creator | CENTORRINO, F BALDESSARINI, R. J FRANKENBURG, F. R KANDO, J VOLPICELLI, S. A FLOOD, J. G |
| description | OBJECTIVE: The selective serotonin reuptake inhibitor (SSRI) fluoxetine
can increase serum levels of clozapine and norclozapine, but effects of
other SSRIs are unknown. Thus, the authors evaluated interactions of
clozapine with fluoxetine, paroxetine, and sertraline. METHOD: Serum
clozapine and norclozapine concentrations were assayed in 80 psychiatric
patients, matched for age and clozapine dose, given clozapine (mean dose =
279 mg/day) alone or with fluoxetine (mean dose = 39.3 mg/day), paroxetine
(mean = 31.2 mg/day), or sertraline (mean = 92.5 mg/ day). Each patient's
dose of clozapine was stable for at least a month before serum sampling.
RESULTS: Concentrations of clozapine plus norclozapine averaged 43% higher,
and the risk of levels higher than 1000 ng/ml was 10-fold greater (25%), in
the patients taking SSRIs, with minor differences between patients taking
the individual SSRIs. CONCLUSIONS: SSRIs can increase circulating
concentrations of clozapine and norclozapine, sometimes to potentially
toxic levels. |
| doi_str_mv | 10.1176/ajp.153.6.820 |
| format | Article |
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can increase serum levels of clozapine and norclozapine, but effects of
other SSRIs are unknown. Thus, the authors evaluated interactions of
clozapine with fluoxetine, paroxetine, and sertraline. METHOD: Serum
clozapine and norclozapine concentrations were assayed in 80 psychiatric
patients, matched for age and clozapine dose, given clozapine (mean dose =
279 mg/day) alone or with fluoxetine (mean dose = 39.3 mg/day), paroxetine
(mean = 31.2 mg/day), or sertraline (mean = 92.5 mg/ day). Each patient's
dose of clozapine was stable for at least a month before serum sampling.
RESULTS: Concentrations of clozapine plus norclozapine averaged 43% higher,
and the risk of levels higher than 1000 ng/ml was 10-fold greater (25%), in
the patients taking SSRIs, with minor differences between patients taking
the individual SSRIs. CONCLUSIONS: SSRIs can increase circulating
concentrations of clozapine and norclozapine, sometimes to potentially
toxic levels.</description><identifier>ISSN: 0002-953X</identifier><identifier>EISSN: 1535-7228</identifier><identifier>DOI: 10.1176/ajp.153.6.820</identifier><identifier>PMID: 8633698</identifier><identifier>CODEN: AJPSAO</identifier><language>eng</language><publisher>Washington, DC: American Psychiatric Publishing</publisher><subject>1-Naphthylamine - adverse effects ; 1-Naphthylamine - analogs & derivatives ; 1-Naphthylamine - therapeutic use ; Adult ; Affective Disorders, Psychotic - blood ; Affective Disorders, Psychotic - drug therapy ; Aged ; Ambulatory Care ; Biological and medical sciences ; Clozapine - analogs & derivatives ; Clozapine - blood ; Clozapine - pharmacology ; Clozapine - therapeutic use ; Drug Interactions ; Drug Therapy, Combination ; Drugs ; Fluoxetine - adverse effects ; Fluoxetine - therapeutic use ; Humans ; Medical sciences ; Middle Aged ; Neuropharmacology ; Paroxetine - adverse effects ; Paroxetine - therapeutic use ; Pharmacology ; Pharmacology. Drug treatments ; Psychiatry ; Psycholeptics: tranquillizer, neuroleptic ; Psychology. Psychoanalysis. Psychiatry ; Psychopharmacology ; Schizophrenia - blood ; Schizophrenia - drug therapy ; Serotonin Uptake Inhibitors - adverse effects ; Serotonin Uptake Inhibitors - pharmacology ; Sertraline ; Stimulation, Chemical</subject><ispartof>The American journal of psychiatry, 1996-06, Vol.153 (6), p.820-822</ispartof><rights>1996 INIST-CNRS</rights><rights>Copyright American Psychiatric Association Jun 1996</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a407t-557daeb1c944c279ecb59799a499d73b82bdb9e07eef51d1169c3c2ba36e90303</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://psychiatryonline.org/doi/epdf/10.1176/ajp.153.6.820$$EPDF$$P50$$Gappi$$H</linktopdf><linktohtml>$$Uhttps://psychiatryonline.org/doi/full/10.1176/ajp.153.6.820$$EHTML$$P50$$Gappi$$H</linktohtml><link.rule.ids>314,780,784,2859,21629,27869,27924,27925,77791,77792</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3128084$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8633698$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CENTORRINO, F</creatorcontrib><creatorcontrib>BALDESSARINI, R. J</creatorcontrib><creatorcontrib>FRANKENBURG, F. R</creatorcontrib><creatorcontrib>KANDO, J</creatorcontrib><creatorcontrib>VOLPICELLI, S. A</creatorcontrib><creatorcontrib>FLOOD, J. G</creatorcontrib><title>Serum levels of clozapine and norclozapine in patients treated with selective serotonin reuptake inhibitors</title><title>The American journal of psychiatry</title><addtitle>Am J Psychiatry</addtitle><description>OBJECTIVE: The selective serotonin reuptake inhibitor (SSRI) fluoxetine
can increase serum levels of clozapine and norclozapine, but effects of
other SSRIs are unknown. Thus, the authors evaluated interactions of
clozapine with fluoxetine, paroxetine, and sertraline. METHOD: Serum
clozapine and norclozapine concentrations were assayed in 80 psychiatric
patients, matched for age and clozapine dose, given clozapine (mean dose =
279 mg/day) alone or with fluoxetine (mean dose = 39.3 mg/day), paroxetine
(mean = 31.2 mg/day), or sertraline (mean = 92.5 mg/ day). Each patient's
dose of clozapine was stable for at least a month before serum sampling.
RESULTS: Concentrations of clozapine plus norclozapine averaged 43% higher,
and the risk of levels higher than 1000 ng/ml was 10-fold greater (25%), in
the patients taking SSRIs, with minor differences between patients taking
the individual SSRIs. CONCLUSIONS: SSRIs can increase circulating
concentrations of clozapine and norclozapine, sometimes to potentially
toxic levels.</description><subject>1-Naphthylamine - adverse effects</subject><subject>1-Naphthylamine - analogs & derivatives</subject><subject>1-Naphthylamine - therapeutic use</subject><subject>Adult</subject><subject>Affective Disorders, Psychotic - blood</subject><subject>Affective Disorders, Psychotic - drug therapy</subject><subject>Aged</subject><subject>Ambulatory Care</subject><subject>Biological and medical sciences</subject><subject>Clozapine - analogs & derivatives</subject><subject>Clozapine - blood</subject><subject>Clozapine - pharmacology</subject><subject>Clozapine - therapeutic use</subject><subject>Drug Interactions</subject><subject>Drug Therapy, Combination</subject><subject>Drugs</subject><subject>Fluoxetine - adverse effects</subject><subject>Fluoxetine - therapeutic use</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neuropharmacology</subject><subject>Paroxetine - adverse effects</subject><subject>Paroxetine - therapeutic use</subject><subject>Pharmacology</subject><subject>Pharmacology. Drug treatments</subject><subject>Psychiatry</subject><subject>Psycholeptics: tranquillizer, neuroleptic</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopharmacology</subject><subject>Schizophrenia - blood</subject><subject>Schizophrenia - drug therapy</subject><subject>Serotonin Uptake Inhibitors - adverse effects</subject><subject>Serotonin Uptake Inhibitors - pharmacology</subject><subject>Sertraline</subject><subject>Stimulation, Chemical</subject><issn>0002-953X</issn><issn>1535-7228</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>K30</sourceid><recordid>eNp1kMtP3DAQxq0KBAvtsUcki3KqlK0f8euIELRISD2USr1FjjMRXrJxsB2q8tdj2BXlAKd5_Wa-0YfQZ0qWlCr5za6mJRV8KZeakQ9oUXJRKcb0DloQQlhlBP-zjw5SWpWScMX20J6WnEujF-j2F8R5jQe4hyHh0GM3hAc7-RGwHTs8hvi_4Uc82exhzAnnCDZDh__6fIMTDOCyv4eSxZDDWMgI85Tt7dPWjW99DjF9RLu9HRJ82sZD9Pvi_PrsR3X18_vl2elVZWuiciWE6iy01Jm6dkwZcK0wyhhbG9Mp3mrWdq0BogB6QTtKpXHcsdZyCYZwwg_R8ebuFMPdDCk3qzDHsUg2jJFaCiNZgb68B1FBNa-10XWhqg3lYkgpQt9M0a9t_NdQ0jzZ3xT7ywJvZFPsL_zR9urcrqF7obd-l_nJdm6Ts0Mf7eh8esE4ZZo8y37dYHaa_KvH3tR8BKffnEU</recordid><startdate>19960601</startdate><enddate>19960601</enddate><creator>CENTORRINO, F</creator><creator>BALDESSARINI, R. J</creator><creator>FRANKENBURG, F. R</creator><creator>KANDO, J</creator><creator>VOLPICELLI, S. A</creator><creator>FLOOD, J. 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J ; FRANKENBURG, F. R ; KANDO, J ; VOLPICELLI, S. A ; FLOOD, J. 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Drug treatments</topic><topic>Psychiatry</topic><topic>Psycholeptics: tranquillizer, neuroleptic</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopharmacology</topic><topic>Schizophrenia - blood</topic><topic>Schizophrenia - drug therapy</topic><topic>Serotonin Uptake Inhibitors - adverse effects</topic><topic>Serotonin Uptake Inhibitors - pharmacology</topic><topic>Sertraline</topic><topic>Stimulation, Chemical</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CENTORRINO, F</creatorcontrib><creatorcontrib>BALDESSARINI, R. J</creatorcontrib><creatorcontrib>FRANKENBURG, F. R</creatorcontrib><creatorcontrib>KANDO, J</creatorcontrib><creatorcontrib>VOLPICELLI, S. A</creatorcontrib><creatorcontrib>FLOOD, J. 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J</au><au>FRANKENBURG, F. R</au><au>KANDO, J</au><au>VOLPICELLI, S. A</au><au>FLOOD, J. G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serum levels of clozapine and norclozapine in patients treated with selective serotonin reuptake inhibitors</atitle><jtitle>The American journal of psychiatry</jtitle><addtitle>Am J Psychiatry</addtitle><date>1996-06-01</date><risdate>1996</risdate><volume>153</volume><issue>6</issue><spage>820</spage><epage>822</epage><pages>820-822</pages><issn>0002-953X</issn><eissn>1535-7228</eissn><coden>AJPSAO</coden><abstract>OBJECTIVE: The selective serotonin reuptake inhibitor (SSRI) fluoxetine
can increase serum levels of clozapine and norclozapine, but effects of
other SSRIs are unknown. Thus, the authors evaluated interactions of
clozapine with fluoxetine, paroxetine, and sertraline. METHOD: Serum
clozapine and norclozapine concentrations were assayed in 80 psychiatric
patients, matched for age and clozapine dose, given clozapine (mean dose =
279 mg/day) alone or with fluoxetine (mean dose = 39.3 mg/day), paroxetine
(mean = 31.2 mg/day), or sertraline (mean = 92.5 mg/ day). Each patient's
dose of clozapine was stable for at least a month before serum sampling.
RESULTS: Concentrations of clozapine plus norclozapine averaged 43% higher,
and the risk of levels higher than 1000 ng/ml was 10-fold greater (25%), in
the patients taking SSRIs, with minor differences between patients taking
the individual SSRIs. CONCLUSIONS: SSRIs can increase circulating
concentrations of clozapine and norclozapine, sometimes to potentially
toxic levels.</abstract><cop>Washington, DC</cop><pub>American Psychiatric Publishing</pub><pmid>8633698</pmid><doi>10.1176/ajp.153.6.820</doi><tpages>3</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-953X |
| ispartof | The American journal of psychiatry, 1996-06, Vol.153 (6), p.820-822 |
| issn | 0002-953X 1535-7228 |
| language | eng |
| recordid | cdi_proquest_journals_220465962 |
| source | MEDLINE; Psychiatry Legacy Collection Online Journals 1844-1996; Periodicals Index Online |
| subjects | 1-Naphthylamine - adverse effects 1-Naphthylamine - analogs & derivatives 1-Naphthylamine - therapeutic use Adult Affective Disorders, Psychotic - blood Affective Disorders, Psychotic - drug therapy Aged Ambulatory Care Biological and medical sciences Clozapine - analogs & derivatives Clozapine - blood Clozapine - pharmacology Clozapine - therapeutic use Drug Interactions Drug Therapy, Combination Drugs Fluoxetine - adverse effects Fluoxetine - therapeutic use Humans Medical sciences Middle Aged Neuropharmacology Paroxetine - adverse effects Paroxetine - therapeutic use Pharmacology Pharmacology. Drug treatments Psychiatry Psycholeptics: tranquillizer, neuroleptic Psychology. Psychoanalysis. Psychiatry Psychopharmacology Schizophrenia - blood Schizophrenia - drug therapy Serotonin Uptake Inhibitors - adverse effects Serotonin Uptake Inhibitors - pharmacology Sertraline Stimulation, Chemical |
| title | Serum levels of clozapine and norclozapine in patients treated with selective serotonin reuptake inhibitors |
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