Relationship of Change in Plasma Clozapine/N-desmethylclozapine Ratio with Cognitive Performance in Patients with Schizophrenia

Article

关键词: N-DESMETHYLCLOZAPINE;    ATYPICAL ANTIPSYCHOTICS;    COMPARATIVE EFFICACY;    MASS-SPECTROMETRY;    METAANALYSIS;    RECEPTOR;    DRUGS;    RELIABILITY;    AGONISM;    SMOKING;   

DOI  :  10.30773/pi.2020.0306

来源: SCIE

【 摘 要 】

Objective The clozapine/N-desmethylclozapine (NDMC) ratio is proposed to be used as a predictor of cognitive performance in clozapine-treated patients, as its principal metabolite, NDMC, has an opposite action with clozapine on the cholinergic system. The aim of this study is to determine whether clozapine has influence on cognitive performance in accordance with changes in the clozapine/NDMC in patients with schizophrenia. Methods The data of fifteen patients with schizophrenia, who had initial and follow-up assessments after starting clozapine treatment, were retrospectively collected. The assessments included clinical scale, cognitive battery, and pharmacological data including plasma concentrations of clozapine and NDMC. The data were analyzed with Pearson correlation and stepwise multiple regression analyses. Results Delta Attention/vigilance, Delta social cognition, and Delta composite score had a significant correlation with Delta clozapine/NDMC ratio, while Delta Working memory had correlation with Delta clozapine concentration and Delta NDMC concentration, and Delta social cognition had association with Delta clozapine concentration. Multiple regression analysis showed that Delta attention/vigilance had negative association with Delta clozapine/NDMC ratio, Delta working memory had negative relation with Delta clozapine concentration, and that Delta social cognition had negative association with Delta clozapine concentration. Conclusion This finding implicates that lowering the clozapine/NDMC ratio could enhance cognition in patients with schizophrenia treated with clozapine.