Although clozapine is the gold standard for treatment-resistant schizophrenia, more than 30% of patients remain unresponsive to clozapine monotherapy and may benefit from augmentation strategies. Fluvoxamine augmentation of clozapine may be beneficial in treatment resistance because of pharmacokinetic interactions, allowing for lower clozapine dosages with higher clozapine serum levels and an increased clozapine-to-norclozapine ratio, which can modify adverse effects. An augmentation strategy using higher fluvoxamine doses may also improve persistent negative, anxiety, and obsessive-compulsive symptoms through fluvoxamine's serotonergic activity.

中文翻译：

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高剂量氟伏沙明在难治性精神病中对氯氮平的增强作用。

尽管氯氮平是治疗难治性精神分裂症的金标准，但仍有超过 30% 的患者对氯氮平单药治疗无反应，可能会受益于强化策略。由于药代动力学相互作用，氯氮平的氟伏沙明增强可能有益于治疗抵抗，允许较低的氯氮平剂量与较高的氯氮平血清水平和增加的氯氮平与去甲氯氮平的比率，这可以改变不良反应。使用更高剂量氟伏沙明的增强策略也可以通过氟伏沙明的血清素活性改善持续的阴性、焦虑和强迫症状。