Abrams Daniel J, Zheng Lijun, Choo Kevin S, Yang Jun J, Wei Wei, Anchordoquy Thomas J, Zawia Nasser H, Stevens Karen E
Department of Psychiatry, University of Colorado at Denver and Health Sciences Center, Aurora, CO 80045, United States.
Schizophr Res. 2008 Mar;100(1-3):86-96. doi: 10.1016/j.schres.2007.10.012. Epub 2008 Jan 7.
While clozapine is the acknowledged superior pharmacotherapeutic for the treatment of schizophrenia, the side effect profile, which includes potentially fatal complications, limits its usefulness. Central administration of clozapine directly into the brain could circumvent many of the side effect issues due to the dramatic reduction in dose and the limitation of the drug primarily to the CNS. The present study demonstrates that clozapine can be formulated as a stable solution at physiological pH, which does not have in vitro neurotoxic effects at concentrations which may be effective at treating symptoms. Acute central administration improved auditory gating deficits in a mouse model of schizophrenia-like deficits. Assessment of behavioral alterations in rats receiving chronic central infusions of clozapine via osmotic minipump was performed with the open field and elevated plus mazes. Neither paradigm revealed any detrimental effects of the infusion. While these data represent only an initial investigation, they none-the-less suggest that central administration of clozapine may be a viable alternate therapeutic approach for schizophrenia patients which may be effective in symptom reduction without causing behavioral or neurotoxic effects.
虽然氯氮平是公认的治疗精神分裂症的 superior pharmacotherapeutic,但包括潜在致命并发症在内的副作用限制了其应用。将氯氮平直接注入大脑中枢可以规避许多副作用问题,因为剂量大幅降低且药物主要局限于中枢神经系统。本研究表明,氯氮平在生理pH值下可配制成稳定溶液,在可能有效治疗症状的浓度下没有体外神经毒性作用。急性中枢给药改善了类似精神分裂症缺陷的小鼠模型中的听觉门控缺陷。通过旷场试验和高架十字迷宫对接受经渗透微型泵慢性中枢输注氯氮平的大鼠的行为改变进行了评估。两种范式均未显示输注有任何有害影响。虽然这些数据仅代表初步研究,但它们仍然表明,氯氮平中枢给药可能是精神分裂症患者一种可行的替代治疗方法,可能有效减轻症状而不引起行为或神经毒性作用。