Effects of the augmentation with quetiapine or olanzapine on the metabolism of duloxetine: a retrospective analysis.

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Expert Review of Clinical Pharmacology Pub Date : 2025-04-04 DOI:10.1080/17512433.2025.2486998

Nele Römer, Arnim Johannes Gaebler, Irene Neuner, Ekkehard Haen, Christoph Hiemke, Georgios Schoretsanitis, Michael Paulzen

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引用次数: 0

Abstract

Background: In antidepressant augmentation strategies, olanzapine or quetiapine are often concomitantly administered to duloxetine. The use of the same enzymes for the degradation of the drugs may lead to clinically relevant drug-drug-interactions, DDIs. So far, DDIs between olanzapine or quetiapine and duloxetine have only been studied in rats or in small numbers of patients.

Methods: Out of a large therapeutic drug monitoring (TDM) database of duloxetine concentrations, three matched study groups were considered to investigate potential DDIs: a group of patients co-medicated with olanzapine (n = 81), a group co-medicated with quetiapine (n = 105) and a control group receiving only duloxetine (n = 105).

Results: Neither in the olanzapine group, nor in the quetiapine group, duloxetine plasma concentrations or dose-adjusted plasma concentrations differed significantly from the control group (p = 0.6759; p = 0.5841). The proportion of patients within the so-called therapeutic reference range was similar in all three groups (p = 0.635). However, smokers showed by 30% lower duloxetine plasma concentrations (p = 0.0179) and 32.5% lower dose-adjusted concentrations (p = 0.0003) compared to nonsmokers.

Conclusion: Our findings indicate that the combination of duloxetine and olanzapine or quetiapine is - from a pharmacokinetic view - a safe treatment option. TDM should be applied in case of co-medications to enhance therapeutic effectiveness and patients' safety.

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喹硫平或奥氮平对度洛西汀代谢的影响：回顾性分析。

背景：在抗抑郁增强策略中，奥氮平或喹硫平常与度洛西汀同时使用。使用相同的酶来降解药物可能导致临床相关的药物-药物相互作用，即DDI。到目前为止，奥氮平或喹硫平与度洛西汀之间的DDI仅在大鼠或少数患者中进行了研究。方法：在一个大型的度洛西汀浓度治疗药物监测（TDM）数据库中，考虑三个匹配的研究组来研究潜在的DDI：与奥氮平联合用药组（n = 81），与喹硫平联合用药组（n = 105）和仅接受度洛西汀治疗的对照组（n = 105）。结果：在奥氮平组和喹硫平组中，度洛西汀的血药浓度和剂量调整后的血药浓度均与对照组无显著差异(p = 0.6759；p = 0.5841)。三组患者在所谓治疗参考范围内的比例相似（p = 0.635）。然而，与不吸烟者相比，吸烟者的度洛西汀血浆浓度降低30% (p = 0.0179)，剂量调整浓度降低32.5% （p = 0.0003）。结论：我们的研究结果表明，从药代动力学的角度来看，度洛西汀与奥氮平或喹硫平联合使用是一种安全的治疗选择。联合用药时应应用TDM，以提高治疗效果和患者安全。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Clinical Pharmacology PHARMACOLOGY & PHARMACY-

CiteScore

7.30

自引率

2.30%

发文量

127

期刊介绍： Advances in drug development technologies are yielding innovative new therapies, from potentially lifesaving medicines to lifestyle products. In recent years, however, the cost of developing new drugs has soared, and concerns over drug resistance and pharmacoeconomics have come to the fore. Adverse reactions experienced at the clinical trial level serve as a constant reminder of the importance of rigorous safety and toxicity testing. Furthermore the advent of pharmacogenomics and ‘individualized’ approaches to therapy will demand a fresh approach to drug evaluation and healthcare delivery. Clinical Pharmacology provides an essential role in integrating the expertise of all of the specialists and players who are active in meeting such challenges in modern biomedical practice.