Clozapine and norclozapine plasma concentrations and clinical response of treatment-refractory schizophrenic patients.

Autor: Perry, Paul J., Miller, Del D., Arndt, Stephan V., Cadoret, Remi J., Perry, P J, Miller, D D, Arndt, S V, Cadoret, R J
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Zdroj: American Journal of Psychiatry; Feb91, Vol. 148 Issue 2, p231-235, 5p
Abstrakt: Objective: Clozapine, an atypical antipsychotic, has been estimated to be effective in 30% of treatment-refractory schizophrenic patients. The authors hypothesized that if a dose-response relationship was obvious for this drug, the response rate could be significantly amplified.Method: Following an 8-24-day dose titration phase, 29 inpatients with treatment-resistant schizophrenia diagnosed according to DSM-III-R were given a clozapine dose of approximately 400 mg/day for 4 weeks; blood samples were obtained weekly during this period.Results: A receiver operator curve demonstrated that the threshold clozapine plasma concentration for therapeutic response was 350 ng/ml. Sixty-four percent of the patients with clozapine plasma concentrations greater than 350 ng/ml responded, whereas only 22% of the patients with concentrations less than 350 ng/ml responded.Conclusions: Use of clozapine blood levels as a predictor for treatment response in treatment-refractory schizophrenic patients appears worthwhile, since the measurement's sensitivity for response was 64% and the specificity for nonresponse was 78%. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index