Effect of Clonazepam Co-Administered with Clozapine on the Serum Clozapine and Norclozapine Concentration of Patients with Schizophrenia: A Retrospective Survey.

上海精神医学 Pub Date : 2016-12-25 DOI:10.11919/j.issn.1002-0829.216066

Ping Jiang, Zhiguang Lin, Yi Jin, Juanjuan Ren, Hongmei Liu, Huiru Cui, Jijun Wang, Chunbo Li

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引用次数: 2

Abstract

Background: For patients with schizophrenia clozapine (CLZ) is sometimes co-prescribed with clonazepam (CLNAZ). However, the impact of administration of CLZ along with CLNAZ on the serum concentration of CLZ and its major metabolite N-CLZ in schizophrenia is not well understood.

Aim: To investigate the effects of CLNAZ co-medication, patient gender, age and CLZ dosage on serum concentration of CLZ and norclozapine (N-CLZ) in individuals with schizophrenia.

Methods: Serum CLZ and N-CLZ concentrations and demographic data were retrospectively analyzed for 341 patients with schizophrenia. We used SPSS 21.0 to perform stepwise regression to analyze the concentration data and demographics. Variables included in the analysis were: serum concentration of CLZ, N-CLZ, and CLZ dosage, gender, age and CLNAZ co-medication.

Results: (1) CLNAZ co-medication significantly affects serum CLZ and N-CLZ concentration in schizophrenics (p=0.010, p=0.020); (2) CLNAZ co-medication, gender and CLZ dosage significantly affect serum CLZ concentration in patients with schizophrenia (p=0.010, p=0.009, p<0.001). Serum CLZ concentration is negatively correlated with CLNAZ co-medication, and is positively correlated with being female and CLZ dosage; (3) CLNAZ co-medication and CLZ dosage were significantly related to serum N-CLZ concentration in participants (p=0.020, p<0.001). Serum N-CLZ concentration was negatively correlated with CLNAZ comedication, and positively correlated with CLZ dosage.

Conclusion: CLNAZ co-medication is associated with changes in serum CLZ and N-CLZ concentration. It is indicated that gender and/or CLZ dosage are also related to serum CLZ and N-CLZ concentration. Therapeutic drug monitoring and dosage regulation of CLZ should be performed for patients with schizophrenia who are also taking CLNAZ to maintain a safe and effective serum concentration of CLZ and N-CLZ.

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氯硝西泮与氯氮平合用对精神分裂症患者血清氯氮平和去氯氮平浓度影响的回顾性调查。

背景:对于精神分裂症患者，氯氮平(CLZ)有时与氯硝西泮(CLNAZ)合用。然而，CLZ与CLNAZ联合使用对精神分裂症患者血清CLZ及其主要代谢物N-CLZ浓度的影响尚不清楚。目的:探讨CLNAZ合用、患者性别、年龄和剂量对精神分裂症患者血清CLZ和去氯氮平(N-CLZ)浓度的影响。方法:回顾性分析341例精神分裂症患者血清CLZ、N-CLZ浓度及人口学资料。我们使用SPSS 21.0进行逐步回归分析浓度数据和人口统计学。纳入分析的变量为:血清CLZ浓度、N-CLZ浓度、CLZ剂量、性别、年龄、CLNAZ联合用药。结果:(1)CLNAZ联合用药显著影响精神分裂症患者血清CLZ和N-CLZ浓度(p=0.010, p=0.020);(2) CLNAZ联合用药、性别、CLZ用量对精神分裂症患者血清CLZ浓度有显著影响(p=0.010, p=0.009, pp=0.020, p)。结论:CLNAZ联合用药与血清CLZ、N-CLZ浓度变化有关。结果表明，性别和/或CLZ剂量也与血清CLZ和N-CLZ浓度有关。同时服用CLNAZ的精神分裂症患者应进行CLZ治疗药物监测和剂量调节，以维持CLZ和N-CLZ的安全有效的血清浓度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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上海精神医学

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