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Plasma clozapine levels and clinical response for treatment-refractory schizophrenic patients

Plasma clozapine levels and clinical response for treatment-refractory schizophrenic patients

American Journal of Psychiatry 152(2): 179-182

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 suggests that clozapine blood levels are correlated with clinical response.

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Accession: 009202806

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PMID: 7840349

DOI: 10.1176/ajp.152.2.179

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