氯氮平
治疗药物监测
精神分裂症(面向对象编程)
抗精神病药
医学
维生素
不利影响
治疗指标
药理学
维生素D与神经学
内科学
药品
血浆水平
毒性
精神科
作者
Alessandra Manca,Jacopo Mula,Alice Palermiti,Flavio Vischia,David De Cori,S. Venturello,Guido Emanuelli,Domenico Maiese,Miriam Antonucci,Amedeo De Nicolò,Elisa Delia De Vivo,Jessica Cusato,Antonio D’Avolio
标识
DOI:10.1016/j.biopha.2023.115103
摘要
Schizophrenia affects approximately 24 million people worldwide and clozapine is the most effective antipsychotic drug. Nevertheless, its use in therapy is limited due to adverse effects.Therapeutic drug monitoring is a clinical tool useful to reduce the clozapine toxicity. In the literature, papers showed how psychiatric disorders could be associated with low vitamin D levels, but a few studies focusing on its role in affecting clozapine exposure are available. A TDM repository was analyzed: clozapine and vitamin D levels measured with liquid chromatography were considered. 1261 samples obtained from 228 individuals were evaluated: 624 patients (49.5%) showed clozapine plasma levels in therapeutic range (350–600 ng/mL). Clozapine toxic plasma levels (>1000 ng/mL) were more present in winter (p = 0.025), compared to other seasons. Concerning vitamin D, a sub-analysis of 859 samples was performed: 326 (37.81%) were deficient ( ng/mL), 490 (57.12%) had insufficient concentrations (10–30 ng/mL), while 43 (5.02%) had sufficient (>30 ng/mL) levels. A correlation between vitamin D and clozapine plasma levels (p = 0.007, Pearson coefficient=0.093) was observed. The role of seasonal variation in clozapine plasma exposure in psychiatric patients treated with clozapine was suggested. Further studies in larger cohorts are needed in order to clarify these aspects.
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