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Clozapine serum levels

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https://www.readbyqxmd.com/read/28664816/cyp2c19-17-protects-against-metabolic-complications-of-clozapine-treatment
#1
Irina Piatkov, Dorgival Caetano, Yolinda Assur, Sue Lynn Lau, Micheline Coelho, Trudi Jones, Tristan Nguyen, Steven Boyages, Mark McLean
OBJECTIVES: Clozapine (CZ) is the most effective drug for managing treatment-resistant schizophrenic disorders. Its use has been limited due to adverse effects, which include weight gain and new-onset diabetes, but the incidence of these varies between patients. METHODS: We investigated 187 Clozapine Clinic patients (of whom 137 consented for genotyping) for the presence of CYP2C19*17 and its association with CZ and NCZ levels, and clinical outcomes. RESULTS: Thirty-nine percent of genotyped patients were carriers of the CYP2C 19*17 polymorphism...
June 30, 2017: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/28643331/treatment-with-antipsychotics-in-pregnancy-changes-in-drug-disposition
#2
Andreas Austgulen Westin, Malin Brekke, Espen Molden, Eirik Skogvoll, Ingrid Castberg, Olav Spigset
Although pregnancy is known to cause changes in drug pharmacokinetics, little is known about its impact on serum levels of antipsychotics. In this study, we retrospectively assessed 201 routine serum antipsychotic therapeutic drug monitoring concentration measurements obtained from a total of 110 pregnancies in 103 women, and 512 measurements from the same women before and after pregnancy. Serum concentrations in the third trimester were significantly lower than baseline for quetiapine (-76%; CI, -83%, -66%; p<0...
June 23, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28613395/clozapine-dose-for-schizophrenia
#3
REVIEW
Selvizhi Subramanian, Birgit A Völlm, Nick Huband
BACKGROUND: Schizophrenia and related disorders such as schizophreniform and schizoaffective disorder are serious mental illnesses characterised by profound disruptions in thinking and speech, emotional processes, behaviour and sense of self. Clozapine is useful in the treatment of schizophrenia and related disorders, particularly when other antipsychotic medications have failed. It improves positive symptoms (such as delusions and hallucinations) and negative symptoms (such as withdrawal and poverty of speech)...
June 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28599751/association-between-serum-levels-of-glutamate-and-neurotrophic-factors-and-response-to-clozapine-treatment
#4
Amir Krivoy, Eldar Hochman, Kyra-Verena Sendt, Sarah Hollander, Yael Vilner, Mirjana Selakovic, Abraham Weizman, Michal Taler
Clozapine is the only available therapy for about 30% of schizophrenia patients otherwise refractory to antipsychotics. Unfortunately, the mechanism of action of the drug is still unknown and there are no biomarkers that can predict a positive response to clozapine. We aimed to examine serum neurotrophins and glutamate levels as putative biomarkers for clozapine response based on the hypothesized mode-of-action of the compound. Blood samples of 89 chronic schizophrenia patients maintained on clozapine were analyzed in a cross-sectional design...
June 7, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28552881/vitamin-d-deficiency-and-associated-factors-in-patients-with-mental-disorders-treated-in-routine-practice
#5
Svetlana Ristic, Sandra Zivanovic, Dragan R Milovanovic, Vladimir Janjic, Danijela Djokovic, Ana Jovicevic, Marijana Stanojevic Pirkovic, Sanja Kocic
This research aimed to investigate factors associated with vitamin D deficiency and to provide data about its prevalence in patients suffering from different psychiatric illnesses. The study had a cross-sectional design and it included 220 patients of both genders, aged from 19-81 y, with a wide range of mental disorders (F00-F89), and treated in routine ambulatory and hospital practice. The researchers collected data from three sources: medical records, a study questionnaire and biochemical analysis of patients' serum samples (concentration of vitamin D measured as 25(OH)D, calcium, phosphorus, magnesium, sodium and potassium)...
2017: Journal of Nutritional Science and Vitaminology
https://www.readbyqxmd.com/read/28412661/reliable-clinical-serum-analysis-with-reusable-electrochemical-sensor-toward-point-of-care-measurement-of-the-antipsychotic-medication-clozapine
#6
Mijeong Kang, Eunkyoung Kim, Thomas E Winkler, George Banis, Yi Liu, Christopher A Kitchen, Deanna L Kelly, Reza Ghodssi, Gregory F Payne
Clozapine is one of the most promising medications for managing schizophrenia but it is under-utilized because of the challenges of maintaining serum levels in a safe therapeutic range (1-3μM). Timely measurement of serum clozapine levels has been identified as a barrier to the broader use of clozapine, which is however challenging due to the complexity of serum samples. We demonstrate a robust and reusable electrochemical sensor with graphene-chitosan composite for rapidly measuring serum levels of clozapine...
September 15, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28340122/potential-role-of-patients-cyp3a-status-in-clozapine-pharmacokinetics
#7
Katalin Tóth, Gábor Csukly, Dávid Sirok, Ales Belic, Ádám Kiss, Edit Háfra, Máté Déri, Ádám Menus, István Bitter, Katalin Monostory
Background: The atypical antipsychotic clozapine is effective in treatment-resistant schizophrenia; however, the success or failure of clozapine therapy is substantially affected by the variables that impact the clozapine blood concentration. Thus, elucidating the inter-individual differences in clozapine pharmacokinetics can facilitate the personalized therapy. Methods: Since potential role in clozapine metabolism is assigned to CYP1A2, CYP2C19, CYP2D6 and CYP3A enzymes, the association between the patients' CYP-status (CYP genotypes, CYP expression) and clozapine clearance was evaluated in 92 psychiatric patients...
March 18, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28291036/potential-mechanisms-of-hematological-adverse-drug-reactions-in-patients-receiving-clozapine-in-combination-with-proton-pump-inhibitors
#8
Michał Wiciński, Mateusz M Węclewicz, Mateusz Miętkiewicz, Bartosz Malinowski, Elżbieta Grześk, Joanna Klonowska
Clozapine is a second-generation antipsychotic which has proven efficacy in treating the symptoms of schizophrenia. Although clozapine therapy is associated with a number of adverse drug reactions, it is frequently used. One of the most common adverse drug reactions is gastroesophageal reflux disease which is an indication for treatment with proton pump inhibitors (PPIs). Coadministration of clozapine and PPIs increases the risk of hematological adverse drug reactions, including neutropenia and agranulocytosis...
March 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/27871032/level-of-serum-thioredoxin-and-correlation-with-neurocognitive-functions-in-patients-with-schizophrenia-using-clozapine-and-other-atypical-antipsychotics
#9
Alper Bas, Gozde Gultekin, Said Incir, Tuba Ocek Bas, Murat Emul, Alaatin Duran
Thioredoxin is a serum antioxidant that has been investigated in the etiology of schizophrenia. The aim of this study is investigating the relationship between serum thioredoxin levels and cognitive functions in acute psychotic episode and remission state patients with schizophrenia; and examining whether there were differences between patients using clozapine and other atypical antipsychotics; including risperidone, olanzapine and amisulpride. This research was performed in schizophrenia patients hospitalized with acute psychotic episode (n=57), reevaluated patients after the initiation of treatment (mean 16 weeks) (n=46), and healthy controls (n=41)...
January 2017: Psychiatry Research
https://www.readbyqxmd.com/read/27788407/determination-of-clozapine-and-five-antidepressants-in-human-plasma-serum-and-whole-blood-by-gas-chromatography-mass-spectrometry-a-simple-tool-for-clinical-and-postmortem-toxicological-analysis
#10
Vassiliki A Boumba, George Rallis, Petros Petrikis, Theodore Vougiouklakis, Venetsanos Mavreas
In this study, we describe a simple and rapid method for the determination of the antipsychotic drug clozapine and five commonly co-administered antidepressants - bupropion, mirtazapine, sertraline, clomipramine and citalopram - in serum, plasma and whole blood. Sample preparation includes solid phase extraction of analytes and determination of drug concentrations by gas chromatography-mass spectrometry without any derivatization steps. The method was fully validated according to international criteria and can be successfully applied for routine analyses...
December 1, 2016: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/27658459/resistin-as-an-inflammatory-marker-in-patients-with-schizophrenia-treated-with-clozapine
#11
Jari-Pekka Klemettilä, Olli Kampman, Niko Seppälä, Merja Viikki, Mari Hämäläinen, Eeva Moilanen, Esa Leinonen
BACKGROUND: Schizophrenia is associated with excess cardiovascular comorbidity and mortality related to lifestyle factors, such as lack of physical activity, poor diet, and smoking. The prevalence of metabolic syndrome is increased among patients with schizophrenia, with the highest rates among patients on clozapine treatment. Smoking, obesity, physical inactivity, airway inflammation and obstruction, and adipose tissue and inflammatory marker activation are related in systemic inflammation...
February 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/27610173/negative-correlation-between-serum-s100b-and-leptin-levels-in-schizophrenic-patients-during-treatment-with-clozapine-and-risperidone-preliminary-evidence
#12
Narjes Hendouei, Seyed Hamzeh Hosseini, Amin Panahi, Zahra Khazaeipour, Fatemeh Barari, Adeleh Sahebnasagh, Shahram Ala
Recently, extensive efforts have been made to understand the rate of energy expenditure and the weight gain associated with atypical antipsychotic treatment, including identification of markers of obesity risk. In recent years, leptin, an adipocyte hormone, has gained significant interest in psychiatric disorders. S100B has been considered as a surrogate marker for astrocyte-specific damage in neurologic disorders. Also, S100B has been detected in adipose with concentration as high as nervous tissue as a second release source...
2016: Iranian Journal of Pharmaceutical Research: IJPR
https://www.readbyqxmd.com/read/27606316/inflammatory-cytokines-and-antipsychotic-induced-weight-gain-review-and-clinical-implications
#13
REVIEW
Trehani M Fonseka, Daniel J Müller, Sidney H Kennedy
Antipsychotic medications (APs), particularly second-generation APs, are associated with significant weight gain in schizophrenia patients. Recent evidence suggests that the immune system may contribute to antipsychotic-induced weight gain (AIWG) via AP-mediated alterations of cytokine levels. Antipsychotics with a high propensity for weight gain, such as clozapine and olanzapine, influence the expression of immune genes, and induce changes in serum cytokine levels to ultimately down-regulate neuroinflammation...
May 2016: Molecular Neuropsychiatry
https://www.readbyqxmd.com/read/27448522/%C3%AE-hydroxybutyrate-pyruvate-and-metabolic-profiles-in-patients-with-schizophrenia-a-case-control-study
#14
Yu-Chi Huang, Pao-Yen Lin, Yu Lee, Chih-Ching Wu, Su-Ting Hsu, Chi-Fa Hung, Chien-Chih Chen, Mian-Yoon Chong, Chieh-Hsin Lin, Liang-Jen Wang
The disturbances of β-hydroxybutyrate (β-HB) and pyruvate are linked with impaired brain energy utilization which involves in the psychopathology of schizophrenia. This study investigates the difference in levels of β-HB and pyruvate between patients with schizophrenia and healthy controls, and explores their relationship with metabolic profiles and disease characteristics. We recruited 54 physically-health schizophrenic patients and 54 age- and gender-matched healthy control subjects. Blood samples were gathered to determine the serum levels of β-HB and pyruvate and plasma levels of metabolic profiles, including fasting glucose, triglycerides, total cholesterol, high- and low-density lipoprotein-cholesterol and adiponectin...
November 2016: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/27221285/relationship-between-clozapine-dose-serum-concentration-and-clinical-outcome-in-children-and-adolescents-in-clinical-practice
#15
Christopher Wohkittel, Manfred Gerlach, Regina Taurines, Christoph Wewetzer, Stefan Unterecker, Rainer Burger, Diana Schreck, Claudia Mehler-Wex, Marcel Romanos, Karin Egberts
Information on dose- and concentration-related clinical effects of clozapine treatment in children and adolescents is scarce. This study aimed to examine the relationship between dose, serum concentration, and clinical outcome as well as the influencing factors thereof in paediatric patients treated with clozapine. Data from a routine Therapeutic Drug Monitoring (TDM) service between 2004 and 2014 were studied in 68 patients, aged 11-18 years. Severity of illness, therapeutic effectiveness and adverse drug reactions (ADRs) were assessed by standardized means...
August 2016: Journal of Neural Transmission
https://www.readbyqxmd.com/read/27075224/-clozapine-and-the-electronic-cigarette-a-case-study
#16
REVIEW
T S E Nonner, S J Timmer
Electronic cigarettes are becoming increasingly popular and therefore psychiatrists are being confronted more and more frequently by this relatively new phenomenon. We discuss the case of a patient who switched from traditional cigarettes to electronic cigarettes and thereupon had a significant increase in the clozapine serum level. The increased level led to considerable side-effects and, as a result, the patients clozapine dosage had to be reduced. In theory, a rise in the clozapine serum level is to be expected after such a switch...
2016: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/26834968/clozapine-induced-myoclonus-a-case-report-and-review-of-the-literature
#17
REVIEW
Ian J Osborne, Ronan J McIvor
We describe the case of a young man with treatment-resistant schizophrenia, who developed myoclonus during clozapine titration. This subsequently led to a full tonic-clonic seizure. Clozapine treatment can result in a range of seizure-like activity, the most well-known being tonic-clonic seizures. This case highlights the importance of recognizing and treating clozapine-induced myoclonus, as it can herald the onset of a full seizure, even at low serum clozapine levels. We highlight the variety of ways myoclonus can present clinically and suggest treatment options...
December 2015: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/26816428/comparative-study-of-sexual-dysfunction-and-serum-prolactin-level-associated-with-olanzapine-risperidone-and-clozapine-in-patients-with-remitted-schizophrenia
#18
S V Sathish Kumar, Vinod Kumar Sinha
BACKGROUND: Sexual dysfunctions have been a major side effect of the second generation anti-psychotic drugs which often affects treatment compliance in patients with schizophrenia. There is no/few systematic review or research addressing sexual dysfunction and their effect on serum prolactin level among different atypical antipsychotics in India. AIMS: To determine and compare the frequency of sexual dysfunction associated with olanzapine, risperidone, and clozapine and their effect on serum prolactin level in remitted patients with schizophrenia...
October 2015: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/26609657/severe-acute-pancreatitis-neuroleptic-malignant-syndrome-and-grand-mal-seizures-associated-with-elevated-amisulpride-and-low-clozapine-serum-levels
#19
Udo Bonnet, Behnaz Taazimi, Martin Montag, Regine Ronge, Holger Gespers, Ralf Kuhlmann, Dieter Grabbe, Jürgen Jahn
No abstract text is available yet for this article.
December 2015: Psychiatria Danubina
https://www.readbyqxmd.com/read/26503818/complement-3-and-metabolic-syndrome-induced-by-clozapine-a-cross-sectional-study-and-retrospective-cohort-analysis
#20
C Zhang, Y Zhang, J Cai, M Chen, L Song
Metabolic syndrome (MetS) is considered to be an adverse effect of long-term treatment with atypical antipsychotics, particularly clozapine. There is strong evidence that the activation of inflammatory pathways interferes with normal metabolism and contributes to the development of MetS. C3, which is an inflammation molecule, has been reported to be associated with MetS. Because C3 is a heritable trait, we accordingly hypothesized that the gene encoding C3 (C3) would be a candidate gene for inter-individual variation in clozapine-induced MetS...
October 27, 2015: Pharmacogenomics Journal
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