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The use of clozapine plasma levels in optimising therapy

Published online by Cambridge University Press:  02 January 2018

David Taylor  and
Denise Duncan
David Taylor
Affiliation:
The Maudsley Hospital, Denmark Hill, London SE5 8AZ
Denise Duncan
Affiliation:
The Maudsley Hospital, Denmark Hill, London SE5 8AZ
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Clozapine is well known to be an effective treatment for neuroleptic-resistant schizophrenia. However, its use is complicated by a variable and delayed response and by a range of troublesome adverse effects. Current practice is usually to increase the dose initially to around 450 mg/day and then by small increments to a maximum of 900 mg/day according to response and tolerability. While this method is often successful, it has been suggested that a better way of optimising the dose of clozapine might be to monitor plasma concentrations of the drug.

Type
Drug Information Quarterly
Information
Psychiatric Bulletin , Volume 19 , Issue 12 , December 1995 , pp. 753 - 755
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 1995

References

Bondesson, U. & Lindstrom, L. H. (1988) Determination of clozapine and its N-demethylated metabolite in plasma by use of gas chromatography-mass spectrometry with single ion detection. Psychopharmacology, 95, 472–475.Google Scholar
Centorrino, F., Baldessarini, R. J., Flood, J. G., et al (1995) Relation of leukocyte counts during clozapine treatment to serum concentrations of clozapine and metabolites. American Journal of Psychiatry, 152, 610–612.Google Scholar
Centorrino, F., Baldessarini, R. J., Baldessarini, R. J., Kando, J., et al (1994) Serum concentrations of clozapine and its major metabolites: effects of co-treatment with fluoxetine or valproate. American Journal of Psychiatry, 151, 123–125.Google Scholar
Haring, C., Fleischhacker, W. W., Schett, P., et al (1990) Influence of patient-related variables on clozapine levels. American Journal of Psychiatry; 147, 1471–1475.Google Scholar
Haring, C., Fleischhacker, W. W., Meise, M., Humpel, C., et al (1989) Dose-related plasma levels of clozapine: influence of smoking behaviour, sex and age. Psychopharmacology, 99, S38–S40.Google Scholar
Haring, C., Fleischhacker, W. W., Neudorfer, C., Schwitzer, J., et al (1993) EEG alterations in patients treated with clozapine in relation to plasma levels. Psychopharmacology, 114, 97–100.Google Scholar
Hasegawa, M., Gutierrez-Esteinou, R., Way, L., et al (1993) Relationship between clinical efficacy and clozapine concentrations in plasma in schizophrenia: effect of smoking. Journal of Clinical Psychopharmacology, 13, 383–390.Google Scholar
Kane, J., Cooper, T. D., Sachar, E. J., et al (1981) Clozapine: plasma levels and prolactin response. Psychopharmacology, 73, 184–187.Google Scholar
Kronig, M. H., Munne, R. A., Szymanski, S., et al (1995) Plasma clozapine levels and clinical response for treatment-refractory schizophrenic patients. American Journal of Psychiatry, 152, 179–182.Google Scholar
Miller, D. D., Fleming, F., Holman, T. L., et al (1994) Plasma clozapine concentrations as a predictor of clinical response: a follow-up study. Journal of Clinical Psychiatry, 55(9, suppl. B), 117–121.Google Scholar
Perry, P. J., Miller, D. D., Arndt, S. V., et al (1991) Clozapine and norclozapine plasma concentrations and clinical response of treatment refractory schizophrenic patients. American Journal of Psychiatry, 148, 231–235.Google Scholar
Piscitelli, S. C., Frazier, J. A., Mckenna, K., et al (1994) Plasma clozapine and haloperidol concentrations in adolescents with childhood-onset schizophrenia: association with response. Journal of Clinical Psychiatry, 55(9, suppl. B), 94–97.Google Scholar
Pollack, S., Lieberman, J., Kleiner, D., et al (1993) High plasma clozapine levels in tardive dyskinesia. Psychopharmacology Bulletin, 29, 257–262.Google Scholar
Potkin, S. G., Bera, R., Gulasekaram, B., et al (1994) Plasma clozapine concentrations predict clinical response in treatment-resistant schizophrenia. Journal of Clinical Psychiatry, 55(9, suppl. B), 133–136.Google Scholar
Raitasuo, V., Lehtovaara, R., Huttunen, M. O. (1993) Carbamazepine and plasma levels of carbamazepine. American Journal of Psychiatry, 150, 169.Google Scholar
Simpson, G. M. & Cooper, T. A. (1978) Clozapine plasma levels and convulsions. American Journal of Psychiatry, 135, 99–100.Google Scholar
Thorup, M. & Fog, R. (1977) Clozapine treatment of schizophrenic patients. Acta Psychiatrica Scandinavica, 55, 123–126.Google Scholar
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