Study on the daily dose and serum concentration of clozapine in psychiatric patients and possible influencing factors of serum concentration
Abstract Background Clozapine is the most effective drug for treatment-resistant schizophrenia, and the dosage and concentration of clozapine in the treatment of mental illness vary greatly in different populations and are affected by many factors. Methods The serum clozapine concentration of 3734 p...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-023-05078-z |
| _version_ | 1797451897946243072 |
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| author | Taixiu Liu Peng Gao Chuange Xie Heng Zhang Zheng Shi Ruirui Chen |
| author_facet | Taixiu Liu Peng Gao Chuange Xie Heng Zhang Zheng Shi Ruirui Chen |
| author_sort | Taixiu Liu |
| collection | DOAJ |
| description | Abstract Background Clozapine is the most effective drug for treatment-resistant schizophrenia, and the dosage and concentration of clozapine in the treatment of mental illness vary greatly in different populations and are affected by many factors. Methods The serum clozapine concentration of 3734 psychiatric patients was detected, and data on daily dose, sex, age and other medical records were collected for statistical analysis. Results The mean daily dose, mean serum concentration and mean C/D (concentration/dose) ratio of clozapine were 191.02 ± 113.47 mg/day, 326.15 ± 235.66 ng/mL and 1.94 ± 1.25 ng/mL per mg/day, respectively. There was difference in daily dose between sexes, and females had higher daily dose (p <0.01), higher serum clozapine concentrations (p < 0.01) and higher C/D ratios (p < 0.01). There were significant differences in daily dose (p < 0.001), serum drug concentration (p < 0.001) and C/D ratio (p < 0.001) among different age groups. The daily dose decreased with age (p for trend < 0.001), and the C/D ratio increased with age (p for trend < 0.001). Inpatients and outpatients had no difference in daily dose, but inpatients had higher serum concentration (p < 0.001) and C/D ratio (p < 0.001). There was no difference in daily dose among different occupations, but there were significant differences in serum concentration (p < 0.001) and C/D ratio (p < 0.001), and unemployed patients may have higher serum concentration and C/D ratio. Duration of disease, comorbidity, marital status, and psychotic type may influence the daily dose and serum concentration. Conclusions The effective daily dose and serum concentration of clozapine in the study area may be lower than recommended levels, and women have higher serum concentrations and slower metabolic rates. With increasing age, the daily dose decreases, and the metabolic rate slows. Inpatient status and occupation of patients may influence the serum concentration and metabolic rate of clozapine. |
| first_indexed | 2024-03-09T15:00:01Z |
| format | Article |
| id | doaj.art-793396cb176b461ebb3e48afc23e15be |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-03-09T15:00:01Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-793396cb176b461ebb3e48afc23e15be2023-11-26T13:56:16ZengBMCBMC Psychiatry1471-244X2023-08-0123111210.1186/s12888-023-05078-zStudy on the daily dose and serum concentration of clozapine in psychiatric patients and possible influencing factors of serum concentrationTaixiu Liu0Peng Gao1Chuange Xie2Heng Zhang3Zheng Shi4Ruirui Chen5Department of Clinical Laboratory, Shandong Daizhuang HospitalDepartment of Clinical Laboratory, Shandong Daizhuang HospitalDepartment of Clinical Laboratory, Shandong Daizhuang HospitalDepartment of Clinical Laboratory, Shandong Daizhuang HospitalDepartment of Clinical Laboratory, Shandong Daizhuang HospitalDepartment of Clinical Laboratory, Shandong Daizhuang HospitalAbstract Background Clozapine is the most effective drug for treatment-resistant schizophrenia, and the dosage and concentration of clozapine in the treatment of mental illness vary greatly in different populations and are affected by many factors. Methods The serum clozapine concentration of 3734 psychiatric patients was detected, and data on daily dose, sex, age and other medical records were collected for statistical analysis. Results The mean daily dose, mean serum concentration and mean C/D (concentration/dose) ratio of clozapine were 191.02 ± 113.47 mg/day, 326.15 ± 235.66 ng/mL and 1.94 ± 1.25 ng/mL per mg/day, respectively. There was difference in daily dose between sexes, and females had higher daily dose (p <0.01), higher serum clozapine concentrations (p < 0.01) and higher C/D ratios (p < 0.01). There were significant differences in daily dose (p < 0.001), serum drug concentration (p < 0.001) and C/D ratio (p < 0.001) among different age groups. The daily dose decreased with age (p for trend < 0.001), and the C/D ratio increased with age (p for trend < 0.001). Inpatients and outpatients had no difference in daily dose, but inpatients had higher serum concentration (p < 0.001) and C/D ratio (p < 0.001). There was no difference in daily dose among different occupations, but there were significant differences in serum concentration (p < 0.001) and C/D ratio (p < 0.001), and unemployed patients may have higher serum concentration and C/D ratio. Duration of disease, comorbidity, marital status, and psychotic type may influence the daily dose and serum concentration. Conclusions The effective daily dose and serum concentration of clozapine in the study area may be lower than recommended levels, and women have higher serum concentrations and slower metabolic rates. With increasing age, the daily dose decreases, and the metabolic rate slows. Inpatient status and occupation of patients may influence the serum concentration and metabolic rate of clozapine.https://doi.org/10.1186/s12888-023-05078-zClozapineSerum concentrationDaily doseTherapeutic drug monitoring (TDM) |
| spellingShingle | Taixiu Liu Peng Gao Chuange Xie Heng Zhang Zheng Shi Ruirui Chen Study on the daily dose and serum concentration of clozapine in psychiatric patients and possible influencing factors of serum concentration BMC Psychiatry Clozapine Serum concentration Daily dose Therapeutic drug monitoring (TDM) |
| title | Study on the daily dose and serum concentration of clozapine in psychiatric patients and possible influencing factors of serum concentration |
| title_full | Study on the daily dose and serum concentration of clozapine in psychiatric patients and possible influencing factors of serum concentration |
| title_fullStr | Study on the daily dose and serum concentration of clozapine in psychiatric patients and possible influencing factors of serum concentration |
| title_full_unstemmed | Study on the daily dose and serum concentration of clozapine in psychiatric patients and possible influencing factors of serum concentration |
| title_short | Study on the daily dose and serum concentration of clozapine in psychiatric patients and possible influencing factors of serum concentration |
| title_sort | study on the daily dose and serum concentration of clozapine in psychiatric patients and possible influencing factors of serum concentration |
| topic | Clozapine Serum concentration Daily dose Therapeutic drug monitoring (TDM) |
| url | https://doi.org/10.1186/s12888-023-05078-z |
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