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Am J Psychiatry 1995; 152:179-182
Copyright © 1995 by American Psychiatric Association
Plasma clozapine levels and clinical response for treatment-refractory schizophrenic patients
MH Kronig, RA Munne, S Szymanski, AZ Safferman, S Pollack, T Cooper, JM Kane and JA Lieberman
Hillside Hospital, Long Island Jewish Medical Center, Glen Oaks, NY 11004.
OBJECTIVE: The purpose of this study was to determine if plasma clozapine
levels were associated with treatment response. METHOD: To examine this
question, neuroleptic nonresponsive patients with schizophrenia or
schizoaffective disorder were given clozapine, which was titrated to 500
mg/day by day 14 of treatment, and the dose was held fixed at least through
day 21. Subsequently, clozapine doses were adjusted as clinically
indicated, up to a maximum of 900 mg/day. Plasma clozapine levels were
obtained at weeks 3 and 6, and standard clinical ratings (Brief Psychiatric
Rating Scale [BPRS] and Clinical Global Impression) were done at baseline
and at weeks 3 and 6. RESULTS: Data from 45 subjects were analyzed. There
were no correlations between plasma clozapine levels and change in BPRS
scores at treatment weeks 3 and 6. However, when the subjects were
classified as responders or nonresponders, therapeutic response was
associated with clozapine blood levels above 350 ng/ml. CONCLUSIONS: This
study suggest that clozapine blood levels are correlated with clinical
response.
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13 - 13.
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