Jiang Ping, Lin Zhiguang, Jin Yi, Ren Juanjuan, Liu Hongmei, Cui Huiru, Wang Jijun, Li Chunbo
Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Postcode: 200030.
Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Postcode: 100101.
Shanghai Arch Psychiatry. 2016 Dec 25;28(6):318-325. doi: 10.11919/j.issn.1002-0829.216066.
For patients with schizophrenia clozapine (CLZ) is sometimes co-prescribed with clonazepam (CLNAZ). However, the impact of administration of CLZ along with CLNAZ on the serum concentration of CLZ and its major metabolite N-CLZ in schizophrenia is not well understood.
To investigate the effects of CLNAZ co-medication, patient gender, age and CLZ dosage on serum concentration of CLZ and norclozapine (N-CLZ) in individuals with schizophrenia.
Serum CLZ and N-CLZ concentrations and demographic data were retrospectively analyzed for 341 patients with schizophrenia. We used SPSS 21.0 to perform stepwise regression to analyze the concentration data and demographics. Variables included in the analysis were: serum concentration of CLZ, N-CLZ, and CLZ dosage, gender, age and CLNAZ co-medication.
(1) CLNAZ co-medication significantly affects serum CLZ and N-CLZ concentration in schizophrenics (=0.010, =0.020); (2) CLNAZ co-medication, gender and CLZ dosage significantly affect serum CLZ concentration in patients with schizophrenia (=0.010, =0.009, <0.001). Serum CLZ concentration is negatively correlated with CLNAZ co-medication, and is positively correlated with being female and CLZ dosage; (3) CLNAZ co-medication and CLZ dosage were significantly related to serum N-CLZ concentration in participants (=0.020, <0.001). Serum N-CLZ concentration was negatively correlated with CLNAZ comedication, and positively correlated with CLZ dosage.
CLNAZ co-medication is associated with changes in serum CLZ and N-CLZ concentration. It is indicated that gender and/or CLZ dosage are also related to serum CLZ and N-CLZ concentration. Therapeutic drug monitoring and dosage regulation of CLZ should be performed for patients with schizophrenia who are also taking CLNAZ to maintain a safe and effective serum concentration of CLZ and N-CLZ.
对于精神分裂症患者，氯氮平（CLZ）有时会与氯硝西泮（CLNAZ）联合使用。然而，CLZ与CLNAZ联合给药对精神分裂症患者血清中CLZ及其主要代谢产物N - CLZ浓度的影响尚不清楚。
研究CLNAZ联合用药、患者性别、年龄和CLZ剂量对精神分裂症患者血清CLZ和去甲氯氮平（N - CLZ）浓度的影响。
对341例精神分裂症患者的血清CLZ和N - CLZ浓度及人口统计学数据进行回顾性分析。我们使用SPSS 21.0进行逐步回归分析浓度数据和人口统计学特征。分析中纳入的变量包括：血清CLZ浓度、N - CLZ浓度、CLZ剂量、性别、年龄和CLNAZ联合用药情况。
（1）CLNAZ联合用药显著影响精神分裂症患者的血清CLZ和N - CLZ浓度（P = 0.010，P = 0.020）；（2）CLNAZ联合用药、性别和CLZ剂量显著影响精神分裂症患者的血清CLZ浓度（P = 0.010，P = 0.009，P < 0.001）。血清CLZ浓度与CLNAZ联合用药呈负相关，与女性及CLZ剂量呈正相关；（3）CLNAZ联合用药和CLZ剂量与参与者的血清N - CLZ浓度显著相关（P = 0.020，P <
