No abstract available.
Angioedema* ; Fluoxetine* ; Urticaria*

Recent studies have reported that obsessive-compulsive (OC) symptoms are highly prevalent in schizophrenia, and schizophrenic patients with OC symptoms have a poorer clinical course compared to those without OC symptoms. In spite of many previous case reports, treatment of OC symptoms in schizophrenia has not been systematically studied. We report a patient with chronic schizophrenia who had obsessive symptoms such as bizarre, stereotyped behaviors. Treatment with olanzapine and risperidone, resulted in partial response for his psychotic symptoms, respectively. The obsessive symptoms, however, persisted and fluoxetine was added to the risperidone regimen. After 4 weeks of combination treatment, fluoxetine was titrated up to 80 mg/day and his obsessive symptoms became less in frequency and intensity. After 7 weeks on combination treatment of risperidone and fluoxetine, obsessive symptoms resulted in a significant reduction. On the 20 months of following, he remained in a recovered state and had been treated with risperidone 4 mg/day, and fluoxetine 20 mg/day.
Fluoxetine ; Humans ; Risperidone ; Schizophrenia ; Stereotyped Behavior

We hereupon present a case of injured temporomandibular joint (TMJ) associated with fluoxetine monotherapy-induced repeated yawning. Further information is needed regarding the relationship between fluoxetine administration and clinically significant yawning. Clinicians should be more careful to listen to their patients when they describe unexpected reactions to medications.
Fluoxetine ; Humans ; Rhinitis* ; Temporomandibular Joint ; Yawning

OBJECTIVES: The authors have intended to know the drug interaction of fluoxetine and haloperidol when coadministering two drugs to the chronic schizophrenics by assessing the changes of positive, negative symptoms and extrapyramidal symptoms. METHOD: We selected 38 patients, the chronic schizophrenics with no physical problems. they are randomly assigned to placebo group and drug group. And then, placebo or fluoxetine 20mg were administered to the subjects of each group during 8 week period. We have assessed their psychopathology and extrapyramidal symptoms using positive and Negative Syndrome Scale(PANSS), Clinical Global Impression(CGI), Simpson-Angus Scale at o, 2, 4, 6, 8 week during the period. RESULTS: 38 patients have completed the study during 8 week. 1) PANSS, CGI : no significant difference between groups and no significant change according to the times. 2) Simpson-Angus Scale : no significant changes. CONCLUSION: When co-administering fluoxetine and haloperidol, there were no significant changes of psychopathology and extrapyramidal symptoms. There results suggest that it is safe to coadminister fluoxetine to schizophrenic with haloperidol treatment.
Drug Interactions ; Fluoxetine* ; Haloperidol* ; Humans ; Psychopathology*

Many psychotropic drugs are marketed and prescribed as a racemate form in a mixture of the stereoisomers. A chiral center or a center of unsaturation of carbon atoms in the chemical structures creates various stereoisomers of the psychotropic drugs, including antidepressants such as fluoxetine and venlafaxine, etc. The stereochemical significances of enantiomers on the pharmacokinetics and pharmacodynamics of several psychotropic drugs and their relationships with pharmacogenetic polymorphisms were reviewed. The single enantiomer drugs will be increasing more in the market shares replacing the racemic drugs by chiral switching, which is driven by the development of the analytical and preparative resolution techniques and will be of much benefit to the treatment from low dosages, simple dose-response curve, few adverse reactions, and so on.
Antidepressive Agents ; Carbon ; Fluoxetine ; Pharmacokinetics ; Psychotropic Drugs* ; Stereoisomerism ; Venlafaxine Hydrochloride

OBJECTIVE: Post-marketing surveillance (PMS) is an adverse events monitoring practice of pharmaceutical drugs on the market. Traditional PMS methods are labor intensive and expensive to perform, because they are largely based on manual work including phone-calling, mailing, or direct visits to relevant subjects. The objective of this study was to develop and validate a PMS methodology based on the clinical data warehouse (CDW). METHODS: We constructed a archival DB using a hospital information system and a refined CDW from three different hospitals. Fluoxetine hydrochloride, an antidepressant, was selected as the target monitoring drug. Corrected QT prolongation on ECG was selected as the target adverse outcome. The Wilcoxon signed rank test was performed to analyze the difference in the corrected QT interval before and after the target drug administration. RESULTS: A refined CDW was successfully constructed from three different hospitals. Table specifications and an entity-relation diagram were developed and are presented. A total of 13 subjects were selected for monitoring. There was no statistically significant difference in the QT interval before and after target drug administration (p=0.727). CONCLUSION: The PMS method based on CDW was successfully performed on the target drug. This IT-based alternative surveillance method might be beneficial in the PMS environment of the future.
Electrocardiography ; Fluoxetine ; Hospital Information Systems ; Postal Service ; Retrospective Studies

OBJECTIVES: CREB (c-AMP response element binding protein) is known as a key mediator of the therapeutic response to antidepressants. We investigated the change of CREB-phosphorylation (pCREB) at the early point of the fluoxetine treatment to find out it can be a predictor for antidepressant response. METHODS: We evaluated the pCREB of T - lymphocyte nuclear extracts from 18 depressed patients at 0 and 1th week during fluoxetine treatment (20 mg/day). Responders were defined as the > or = 50% reduction of HAM-D score in 4 weeks. We compared the changes of pCREB at 0 and 1th week between responders and non-responders. RESULTS: The responders showed a significant increase of pCREB at week 1 compared with week 0. The HAM-D difference between week 0 and 4 was positively correlated with the change of pCREB response. CONCLUSION: These results suggest that the early change of pCREB in peripheral lymphocyte can predict the later response of antidepressant. The correlation showed pCREB directly reflects a response status to the antidepressant fluoxetine and clinical improvement.
Antidepressive Agents ; Depression ; Fluoxetine ; Humans ; Lymphocytes ; Response Elements

OBJECTIVES: CREB (c-AMP response element binding protein) is known as a key mediator of the therapeutic response to antidepressants. We investigated the change of CREB-phosphorylation (pCREB) at the early point of the fluoxetine treatment to find out it can be a predictor for antidepressant response. METHODS: We evaluated the pCREB of T - lymphocyte nuclear extracts from 18 depressed patients at 0 and 1th week during fluoxetine treatment (20 mg/day). Responders were defined as the > or = 50% reduction of HAM-D score in 4 weeks. We compared the changes of pCREB at 0 and 1th week between responders and non-responders. RESULTS: The responders showed a significant increase of pCREB at week 1 compared with week 0. The HAM-D difference between week 0 and 4 was positively correlated with the change of pCREB response. CONCLUSION: These results suggest that the early change of pCREB in peripheral lymphocyte can predict the later response of antidepressant. The correlation showed pCREB directly reflects a response status to the antidepressant fluoxetine and clinical improvement.
Antidepressive Agents ; Depression ; Fluoxetine ; Humans ; Lymphocytes ; Response Elements

The selective serotonin reuptake inhibitor fluoxetine is one of the most frequently prescribed drugs for the treatment of depression and other psychiatric disorders. In the few years, there have been several reports of adverse effects encountered during coadministration of fluoxetine with or without other psychotropic drugs. We experienced three cases of extrapyamidal symptoms were developed when administered fluoxetine alone and with neuroleptics. We conclude that there is a probable or possible causal relationship between fluoxetine and extrapyramidal side effects. The pathogenesis of such adverse reactions, which may be hetero-geneous, is unknown, but it has been suggested that they might be caused by serotonergically mediated inhibition of dopaminergic transmission. From reports in those cases, it appears that fluoxetine alone may be associated with extrapyramidal side reactions. Furthermore the potential for increased levels of concomitant psychotropic medicines and increased side effects, should be borne in mind.
Antipsychotic Agents ; Depression ; Fluoxetine* ; Psychomotor Agitation ; Psychotropic Drugs ; Serotonin

OBJECTIVE: The purpose of this study was to compare the plasma amitriptyline and nortriptyline level between before and after fluoxetine addition with patients who were currently taking amitriptyline. METHOD: From the inpatient and outpatient unit of Soon Chun Hyang University Hospital, Chunan, fourteen subjects who were taking amitriptyline 25mg more than 1 week at least were given fluoxetine 20mg. Before and 2 weeks after fluoxetine addition the plasma level of amitriptyline and nortriptyline are analyzed simultaneously by High Performance Liquid Chromatography(HPLC) At the same times, HAM-D(Hamilton Rating Scale for Depression) score and the UKU(Uldvalg for Klinske Unders phi gelser) side effect scale were checked. RESULTS: After fluoxetine addition to the patients who were taking amitriptyline, the plasma level of amitriptyline, nortriptyline and sum of amitriptyline and nortriptyline had risen. The mean plasma amitriptyline level increased from 168.9+/-89.4ng/ml to 183.0+/-102.0ng/ml after fluoxetine addition(p=0.011) but the change was not statistically significant. The mean plasma nortriptyline level increased significantly from 114.3+/-70.2ng/ml to 168.0+/-86.2ng/ml after fluoxetine addition(p=0.011) In addition, the mean plasma level of total amitriptyline and nortriptyline increased significantly from 283.1+/-125.3ng/ml to 350.9+/-78.4ng/ml after fluoxetine addition(p=0.016) After fluoxetine addition, no significant change was noted in the UKU side effect scale score. CONCLUSION: As consequence of comparson of plasma amitriptyline and nortriptyline level before and after fluoxetine addition mean amitriptyline, nortriptyline and total plasma level was increased after fluoxetine addition. This suggests that coadministration of amitriptyline and fluoxetine may induce improvement of depressive symptom in depressive patients by way of increased plasma level of amitriptyline.
Amitriptyline* ; Chungcheongnam-do ; Depression ; Fluoxetine* ; Humans ; Inpatients ; Nortriptyline ; Outpatients ; Plasma*