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精神分裂症和分裂情感性障碍患者的血浆氯氮平浓度。

Concentrations in plasma clozapine levels in schizophrenic and schizoaffective patients.

机构信息

Universidad de Oviedo, CIBERSAM, Oviedo, España; Hospital Valle del Nalón (SESPA), Langreo, España.

Área de Psiquiatría, Universidad de Oviedo, Oviedo, España.

出版信息

Rev Psiquiatr Salud Ment. 2017 Oct-Dec;10(4):192-196. doi: 10.1016/j.rpsm.2017.06.002. Epub 2017 Aug 31.

Abstract

INTRODUCTION

There is great variability in plasma levels of clozapine. The objective of this study is to know the characteristics of patients treated with clozapine and the relationship between them and the variability of plasma levels.

MATERIAL AND METHODS

Descriptive, cross-sectional study of all patients currently treated with clozapine in a Psychiatric Service with a diagnosis of schizophrenic psychosis or schizoaffective disorder. The present study assessed physical situation, psychopathology and functionality of the patients and explored the associations and correlations between clinical variables and plasma levels.

RESULTS

We studied 39 patients, predominantly men, with negative and depressive symptoms and cardiovascular risk factors (metabolic syndrome and smoking). Significant variability in dose and even greater in clozapine levels were observed. The levels of clozapine at equal doses/kg of body weight were higher in non-smokers, they had positive correlation with BMI and negative correlation with systolic BP, disruptive behaviors and number of cigarettes consumed.

CONCLUSION

Plasma level monitoring clozapine is an important tool to avoid clozapine plasma levels monitoring and minimize undesirable clinical situations (metabolic syndrome, sedation, negative symptoms and functional impairment). It is also important to control the effects of a smoking habit for optimum drug bioavailability.

摘要

简介

氯氮平的血浆水平存在很大的变异性。本研究的目的是了解接受氯氮平治疗的患者的特征,以及他们与血浆水平变异性之间的关系。

材料与方法

对一家精神病科服务机构中目前正在接受氯氮平治疗的所有被诊断为精神分裂症或分裂情感障碍的患者进行描述性、横断面研究。本研究评估了患者的身体状况、精神病理学和功能,并探讨了临床变量与血浆水平之间的关联和相关性。

结果

我们研究了 39 名患者,主要是男性,存在阴性和抑郁症状以及心血管危险因素(代谢综合征和吸烟)。观察到剂量的显著变异性,甚至更高的氯氮平水平。在相同剂量/体重公斤的情况下,非吸烟者的氯氮平水平更高,与 BMI 呈正相关,与收缩压、破坏性行为和吸烟量呈负相关。

结论

氯氮平的血浆水平监测是一个重要的工具,可以避免氯氮平的血浆水平监测,并最大限度地减少不良的临床情况(代谢综合征、镇静、阴性症状和功能障碍)。控制吸烟习惯对药物最佳生物利用度也很重要。

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