难治性精神分裂症患者的血浆氯氮平水平与临床反应

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

作者信息

Kronig M H, Munne R A, Szymanski S, Safferman A Z, Pollack S, Cooper T, Kane J M, Lieberman J A

机构信息

Hillside Hospital, Long Island Jewish Medical Center, Glen Oaks, NY 11004.

出版信息

Am J Psychiatry. 1995 Feb;152(2):179-82. doi: 10.1176/ajp.152.2.179.

DOI:10.1176/ajp.152.2.179

PMID:7840349

Abstract

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 suggest that clozapine blood levels are correlated with clinical response.

摘要

目的

本研究旨在确定血浆氯氮平水平是否与治疗反应相关。

方法

为探讨这一问题，对患有精神分裂症或分裂情感性障碍的抗精神病药物无反应患者给予氯氮平，在治疗第14天滴定至500毫克/天，并至少维持该剂量至第21天。随后，根据临床指征调整氯氮平剂量，最高可达900毫克/天。在第3周和第6周测定血浆氯氮平水平，并在基线、第3周和第6周进行标准临床评定（简明精神病评定量表[BPRS]和临床总体印象）。