González-Esquivel Dinora F, Castro Nelly, Ramírez-Bermúdez Jesús, Custodio Verónica, Rojas-Tomé Susana, Castro-Román Rafael, Jung-Cook Helgi
Instituto Nacional de Neurología y Neurocirugía, México D F, México.
Arzneimittelforschung. 2011;61(6):335-9. doi: 10.1055/s-0031-1296207.
The aim of the present study was to determine the prescribing practice for clozapine (CAS 5786-21-0) as well as the plasma levels of clozapine and its main metabolite norclozapine (CAS 6104-71-8) in Mexican patients. A prospective study was performed in 69 in and out psychotic patients taking clozapine. Blood samples were taken at steady state. Plasma concentrations of clozapine and norclozapine were determined by HPLC. The results showed that the mean daily dose administered was 250 mg/d. Plasma levels showed a large interindividual variability. Mean plasma levels were 411.3 +/- 328.12 ng/mL, for clozapine and 172.0 +/- 129.9 ng/mL for norclozapine. When data were compared with those reported in other populations, it was found that although the dose was lower than that reported in Caucasians, the plasma levels were similar. As a result, the predictive models for the estimation of clozapine concentration in Caucasians were not appropriate for application in Mexican patients. The findings suggest ethnic differences in the ratio dose/plasma levels of clozapine in Mexican patients. Further studies are required to expand the observations.
本研究的目的是确定墨西哥患者中氯氮平（CAS 5786-21-0）的处方习惯以及氯氮平及其主要代谢物去甲氯氮平（CAS 6104-71-8）的血浆水平。对69名服用氯氮平的住院和门诊精神病患者进行了一项前瞻性研究。在稳态时采集血样。采用高效液相色谱法测定氯氮平和去甲氯氮平的血浆浓度。结果显示，平均每日给药剂量为250mg/d。血浆水平显示出较大的个体间差异。氯氮平的平均血浆水平为411.3±328.12ng/mL，去甲氯氮平为172.0±129.9ng/mL。当将数据与其他人群报告的数据进行比较时，发现尽管剂量低于白种人报告的剂量，但血浆水平相似。因此，用于估计白种人氯氮平浓度的预测模型不适用于墨西哥患者。研究结果表明，墨西哥患者氯氮平剂量/血浆水平的比例存在种族差异。需要进一步研究以扩大观察范围。
