High-dose fluoxetine in the treatment of depressed patients not responsive to a standard dose of fluoxetine
ABSTRACT In a four-week, open label study of major depression, 15 patients who had failed to respond to a trial of fluoxetine 20 mg/day of 8–12 weeks duration were then treated with fluoxetine 40 mg/day for one week and then, if tolerated, with either 60 or 80 mg/day. The mean HAM-D-17 and CGIS scores of these 15 patients decreased significantly at the end of 4 weeks on a higher dosage of fluoxetine (60 or 80 mg/day) with respect to the beginning of the four-week study. No significant side-effects were noted.
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ABSTRACT: Selective serotonin re-uptake inhibitors are often combined with tricyclic antidepressants (TCA) in the aim of optimalizing pharmacotherapy of the psychiatric patient. However, the real clinical benefit is still not well documented, but it is known, that fluoxetine and fluvoxamine interact with TCAs by increasing their plasma levels. Several reports describe the manifestation of severe adverse effects during such combination therapies. Case studies with citalopram correlate with in vitro investigations, in that citalopram is less likely to interact with TCAs at the pharmacokinetic level. Clinical studies are needed to evaluate the risk and benefit of a combination of other SSRIs such as paroxetine and sertraline, which are also potent inhibitors of cytochrome P-4502D6, an isozyme implicated in the metabolism of TCAs.Nordic Journal of Psychiatry 01/1993; 47:13-19. DOI:10.3109/08039489309104120 · 1.50 Impact Factor
Journal of the American Psychiatric Nurses Association 01/1997; 3(1):17-21. DOI:10.1177/107839039700300104
Journal of the American Psychiatric Nurses Association 02/1997; 3(1):17-21. DOI:10.1016/S1078-3903(97)90010-0