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Clozapine and norclozapine plasma concentrations and clinical response of treatment-refractory schizophrenic patients
Journal article   Peer reviewed

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

P J Perry, D D Miller, S V Arndt and R J Cadoret
The American journal of psychiatry, Vol.148(2), pp.231-235
02/1991
DOI: 10.1176/ajp.148.2.231
PMID: 1670979

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Abstract

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. 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. 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. 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%.
 Schizophrenia - blood Clozapine - administration & dosage Humans Middle Aged Clinical Protocols Male Chromatography, High Pressure Liquid Clozapine - analogs & derivatives Schizophrenic Psychology Psychiatric Status Rating Scales Antipsychotic Agents - therapeutic use Sensitivity and Specificity Adult Female ROC Curve Clozapine - blood Schizophrenia - drug therapy

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