Pharmacoclinical dosing strategy in neuroleptic resistant schizophrenic patients treated by clozapine: Clinical evolution, plasma and red blood cell clozapine and desmethylclozapine and whole blood serotonin

Intramuscular Aripiprazole in the Acute Management of Psychomotor Agitation

“…42 Studies with clozapine showed doubtful correlations between blood concentrations and clinical response, but they did identify a concentration threshold cut-off or a therapeutic window to validate the use of therapeutic drug monitoring. [43][44][45][46][47][48][49] No correlation was found between blood levels and clinical effect for risperidone and paliperidone (9-hydroxyrisperidone), [50][51][52][53][54][55][56][57] although an unreplicated study found a therapeutic window. 51 Plasma levels of ziprasidone are unpredictably related to dose and do not correlate with symptom improvement, except for negative symptoms assessed with the PANSS.…”

“…Inconsistent results have been obtained for olanzapine, and a correlation between quetiapine plasma levels and clinical response measured through the Brief Psychiatric Rating Scale was found in one study . Studies with clozapine showed doubtful correlations between blood concentrations and clinical response, but they did identify a concentration threshold cut‐off or a therapeutic window to validate the use of therapeutic drug monitoring . No correlation was found between blood levels and clinical effect for risperidone and paliperidone (9‐hydroxyrisperidone), although an unreplicated study found a therapeutic window .…”

Antipsychotic drugs elevate mRNA levels of presynaptic proteins in the frontal cortex of the rat

“…We chose the conventional APD, haloperidol and the atypical APD, clozapine, because of their broad use in patients and in animal models (Fibiger 1994;Frankenburg 1999;Kane and Marder 1993;Konradi and Heckers 2001). Each APD was used at a concentration that is known to induce gene expression in the rat striatum after acute treatment (haloperidol-H, clozapine-H), (Leveque et al 2000;MacGibbon et al 1994;Robertson and Fibiger 1992), and at a second, lower concentration that is within the range of APD concentrations administered in humans (haloperidol-L and clozapine-L) (Aymard et al 1997;Conley et al 1999;Kane and Marder 1993;Purdon et al 2000). The common denominator of the drugs and drug concentrations used is their antipsychotic action in humans, whereas side effects are dissimilar between both types of drugs and between the high and low drug concentrations (Mortimer 2003;Wirshing et al 2003).…”

Adverse Drug Reactions in Relation to Clozapine Plasma Levels: A Systematic Review

“…Four studies examining leucocyte (WBC) and neutrophil (NEU) counts in relation to clozapine levels yielded negative results [ 35 , 36 , 37 , 69 ]. No case of agranulocytosis was reported in an open-label study with seven chronic paranoid schizophrenic patients [ 84 ]. Similarly no correlation was found with eosinophilia [ 37 ], increased erythrocyte folate concentration [ 35 ], lymphocyte number [ 37 , 77 ], hemoglobin (HGB) levels and hematocrit [ 37 ].…”