Clozapine effects on neuroendocrine response to apomorphine challenge testing in chronic neuroleptic nonresponsive schizophrenia: Preliminary findings

Szymanski, S.; Lieberman, Jeffrey; Pollack, Simcha; Safferman, Allan Z.; Munne, Rafael; Umbricht, Daniel; Kane, John M.; Kronig, Michael H.; Chakos, Miranda; Cooper, Thomas B.

doi:10.1016/0006-3223(94)00191-5

Cited by 12 publications

(3 citation statements)

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“…This may explain why cortisol, but not GH or PRL, responses to APO, predicted treatment response at six weeks. However, it should be noted that Szymanski et al (1995) previously reported that the APO-induced PRL and GH responses were correlated with response to clozapine at weeks 9 and 12, but not at weeks 3 and 6.…”

Section: The Apo-cortisol Response and Response To Treatmentmentioning

confidence: 68%

The Blunted Plasma Cortisol Response to Apomorphine and Its Relationship to Treatment Response in Patients with Schizophrenia

Meltzer

Lee

Jayathilake

2001

Neuropsychopharmacology

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Section: The Apo-cortisol Response and Response To Treatmentmentioning

confidence: 68%

The Blunted Plasma Cortisol Response to Apomorphine and Its Relationship to Treatment Response in Patients with Schizophrenia

Meltzer

Lee

Jayathilake

2001

Neuropsychopharmacology

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“…One study investigated concentrations of platelet monoamine oxidase B (MAO-B) which metabolizes dopamine ( 68 ), and found a positive association with symptom improvements following clozapine ( 26 ). Finally, as a dopaminergic pharmacological challenge, apomorphine-induced prolactin suppression and growth hormone secretion predicted better clozapine response in a preliminary study ( 67 ).…”

Section: Resultsmentioning

confidence: 96%

Biological Predictors of Clozapine Response: A Systematic Review

et al. 2018

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Background: Clozapine is the recommended antipsychotic for treatment-resistant schizophrenia (TRS) but there is significant variability between patients in the degree to which clozapine will improve symptoms. The biological basis of this variability is unknown. Although clozapine has efficacy in TRS, it can elicit adverse effects and initiation is often delayed. Identification of predictive biomarkers of clozapine response may aid initiation of clozapine treatment, as well as understanding of its mechanism of action. In this article we systematically review prospective or genetic studies of biological predictors of response to clozapine.Methods: We searched the PubMed database until 20th January 2018 for studies investigating “clozapine” AND (“response” OR “outcome”) AND “schizophrenia.” Inclusion required that studies examined a biological variable in relation to symptomatic response to clozapine. For all studies except genetic-studies, inclusion required that biological variables were measured before clozapine initiation.Results: Ninety-eight studies met the eligibility criteria and were included in the review, including neuroimaging, blood-based, cerebrospinal fluid (CSF)-based, and genetic predictors. The majority (70) are genetic studies, collectively investigating 379 different gene variants, however only three genetic variants (DRD3 Ser9Gly, HTR2A His452Tyr, and C825T GNB3) have independently replicated significant findings. Of the non-genetic variables, the most consistent predictors of a good response to clozapine are higher prefrontal cortical structural integrity and activity, and a lower ratio of the dopamine and serotonin metabolites, homovanillic acid (HVA): 5-hydroxyindoleacetic acid (5-HIAA) in CSF.Conclusions: Recommendations include that future studies should ensure adequate clozapine trial length and clozapine plasma concentrations, and may include multivariate models to increase predictive accuracy.

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“…Results employing this procedure have, however, been inconsistent. While several reports have indicated an association between apomorphine-induced GH increase and prolactin decrease (Lieberman et al 1994b;Szymanski et al 1995), other studies have failed to demonstrate such a relationship .…”

Section: Endocrinementioning

confidence: 97%