氟西汀和氯氮平联用与血压升高相关

1例30岁男性,因患抑郁症给予抗精神病药物治疗。患者既往无高血压病史,治疗前血压正常。患者开始单用氯氮平,中午150mg,晚225mg,期间监测血压正常。氯氮平治疗第13天,加用氟西汀,早20mg。联合用药第2天患者出现头晕症状,血压升高到150/105mmHg。减少氯氮平剂量：中午125mg,晚200mg,增加氟西汀剂量：早40mg,患者血压继续升高至160/110mmHg。停用氟西汀,氯氮平进一步减量：中午100mg,晚175mg,2d后血压恢复正常。

Increased blood pressure associated with fluoxetine plus clozapine

A 30-year-old man was treated with antipsychotic drugs for depression. The patient had no history of hypertension and his blood pressure was normal before therapy. He started receiving monotherapy with clozapine 150 mg at noon and 225 mg in the evening, and his blood pressure was normal. On day 13 of clozapine treatment, fluoxetine 20 mg in the morning was added to his regimen. On day 2 of combination therapy, he experienced dizziness and a BP of 150/105 mmHg. After elozapine dosage was reduced to 125 mg at noon and 200 mg in the evening and fluoxetine dosage was increased to 40 rag, his blood pressure increased further to 160/110 mmHg. Therefore, fluoxetine was stopped and clozapine dosage was further reduced to 100 mg at noon and 175 mg in the evening. Two days later, his blood pressure normalized.