The effects of clinical and pharmacological factors on the ratio of clozapine to norclozapine in psychiatric patients
BackgroundDue to its exceptional effectiveness, clozapine (CLO), whose metabolite is norclozapine (NCLO), is a drug of choice in the management of treatment-resistant schizophrenia. The purpose of this study was to assess the factors modifying the CLO/NCLO ratio (CNR).MethodsA total of 446 blood sam...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2024.1518739/full |
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| author | Anna Mach Anna Wnorowska Marcin Siwek Marcin Wojnar Marcin Wojnar Maria Radziwoń-Zaleska |
| author_facet | Anna Mach Anna Wnorowska Marcin Siwek Marcin Wojnar Marcin Wojnar Maria Radziwoń-Zaleska |
| author_sort | Anna Mach |
| collection | DOAJ |
| description | BackgroundDue to its exceptional effectiveness, clozapine (CLO), whose metabolite is norclozapine (NCLO), is a drug of choice in the management of treatment-resistant schizophrenia. The purpose of this study was to assess the factors modifying the CLO/NCLO ratio (CNR).MethodsA total of 446 blood samples (233 of which were drawn from females and 213 from males, aged from 18 to 77 years) were analyzed in this study. The patients were treated at a psychiatric hospital in the period 2016–2021. Serum CLO and NCLO levels were determined with high-performance liquid chromatography coupled with a UV detector.ResultsThe median CNR was 2.38 (minimum 0.30, maximum 14.36). Our analysis showed that neither sex (p= 0.135) nor smoking (p = 0.774) had any significant effect on the CNR. However, increased doses of CLO resulted in lower CNR values (p = 0.005). Concomitant use of other psychotropic drugs increased the CNR (p = 0.001).DiscussionThe results of our study indicate a need for personalized CLO treatment. Assessing the CNR may be useful in identifying CLO interaction with other psychotropic drugs. |
| format | Article |
| id | doaj-art-c671abab59014e1898521c04ac7c21d0 |
| institution | Kabale University |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pharmacology |
| spelling | doaj-art-c671abab59014e1898521c04ac7c21d02025-01-07T05:23:52ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-01-011510.3389/fphar.2024.15187391518739The effects of clinical and pharmacological factors on the ratio of clozapine to norclozapine in psychiatric patientsAnna Mach0Anna Wnorowska1Marcin Siwek2Marcin Wojnar3Marcin Wojnar4Maria Radziwoń-Zaleska5Department of Psychiatry, Medical University of Warsaw, Warsaw, PolandDepartment of Psychiatry, Medical University of Warsaw, Warsaw, PolandDepartment of Affective Disorders, Jagiellonian University Medical College, Cracow, PolandDepartment of Psychiatry, Medical University of Warsaw, Warsaw, PolandDepartment of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, United StatesDepartment of Psychiatry, Medical University of Warsaw, Warsaw, PolandBackgroundDue to its exceptional effectiveness, clozapine (CLO), whose metabolite is norclozapine (NCLO), is a drug of choice in the management of treatment-resistant schizophrenia. The purpose of this study was to assess the factors modifying the CLO/NCLO ratio (CNR).MethodsA total of 446 blood samples (233 of which were drawn from females and 213 from males, aged from 18 to 77 years) were analyzed in this study. The patients were treated at a psychiatric hospital in the period 2016–2021. Serum CLO and NCLO levels were determined with high-performance liquid chromatography coupled with a UV detector.ResultsThe median CNR was 2.38 (minimum 0.30, maximum 14.36). Our analysis showed that neither sex (p= 0.135) nor smoking (p = 0.774) had any significant effect on the CNR. However, increased doses of CLO resulted in lower CNR values (p = 0.005). Concomitant use of other psychotropic drugs increased the CNR (p = 0.001).DiscussionThe results of our study indicate a need for personalized CLO treatment. Assessing the CNR may be useful in identifying CLO interaction with other psychotropic drugs.https://www.frontiersin.org/articles/10.3389/fphar.2024.1518739/fullclozapinenorclozapineclozapine-to-norclozapine ratioclozapine metabolismschizophrenia |
| spellingShingle | Anna Mach Anna Wnorowska Marcin Siwek Marcin Wojnar Marcin Wojnar Maria Radziwoń-Zaleska The effects of clinical and pharmacological factors on the ratio of clozapine to norclozapine in psychiatric patients Frontiers in Pharmacology clozapine norclozapine clozapine-to-norclozapine ratio clozapine metabolism schizophrenia |
| title | The effects of clinical and pharmacological factors on the ratio of clozapine to norclozapine in psychiatric patients |
| title_full | The effects of clinical and pharmacological factors on the ratio of clozapine to norclozapine in psychiatric patients |
| title_fullStr | The effects of clinical and pharmacological factors on the ratio of clozapine to norclozapine in psychiatric patients |
| title_full_unstemmed | The effects of clinical and pharmacological factors on the ratio of clozapine to norclozapine in psychiatric patients |
| title_short | The effects of clinical and pharmacological factors on the ratio of clozapine to norclozapine in psychiatric patients |
| title_sort | effects of clinical and pharmacological factors on the ratio of clozapine to norclozapine in psychiatric patients |
| topic | clozapine norclozapine clozapine-to-norclozapine ratio clozapine metabolism schizophrenia |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1518739/full |
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