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Clozapine ultrarapid metabolism during weak induction probably exists but requires careful diagnosis. A literature review, five new cases and a proposed definition

dc.rights.licenseopenen_US
dc.contributor.authorSCHORETSANITIS, Georgios
dc.contributor.authorANIL YAĞCIOĞLU, A Elif
dc.contributor.authorRUAN, Can-Jun
dc.contributor.authorEAP, Chin B
dc.contributor.authorMOLDEN, Espen
dc.contributor.authorBAPTISTA, Trino
dc.contributor.authorCLARK, Scott R
dc.contributor.authorFERNANDEZ-EGEA, Emilio
dc.contributor.authorKIM, Se Hyun
dc.contributor.authorLANE, Hsien-Yuan
dc.contributor.authorLEUNG, Jonathan
dc.contributor.authorMAROÑAS AMIGO, Olalla
dc.contributor.authorMOTUCA, Mariano
dc.contributor.authorOLMOS, Ismael
dc.contributor.authorEVERY-PALMER, Susanna
dc.contributor.authorPROCYSHYN, Ric M
dc.contributor.authorROHDE, Christopher
dc.contributor.authorSATISH, Suhas
dc.contributor.authorSCHULTE, Peter F J
dc.contributor.authorSPINA, Edoardo
dc.contributor.authorTAKEUCHI, Hiroyoshi
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorVERDOUX, Helene
dc.contributor.authorCORRELL, Christoph U
dc.contributor.authorDE LEON, Jose
dc.date.accessioned2023-09-27T14:21:57Z
dc.date.available2023-09-27T14:21:57Z
dc.date.issued2023-06-01
dc.identifier.issn1573-2509en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/183820
dc.description.abstractEnDuring weak induction (from smoking and/or valproate co-prescription), clozapine ultrarapid metabolizers (UMs) need very high daily doses to reach the minimum therapeutic concentration of 350 ng/ml in plasma; clozapine UMs need clozapine doses higher than: 1) 900 mg/day in patients of European/African ancestry, or 2) 600 mg/day in those of Asian ancestry. Published clozapine UMs include 10 males of European/African ancestry, mainly assessed with single concentrations. Five new clozapine UMs (two of European and three of Asian ancestry) with repeated assessments are described. A US double-blind randomized trial included a 32-year-old male smoking two packages/day with a minimum therapeutic dose of 1,591 mg/day from a single TDM during open treatment of 900 mg/day. In a Turkish inpatient study, a 30-year-old male smoker was a possible clozapine UM needing a minimum therapeutic dose of 1,029 mg/day estimated from two trough steady-state concentrations on 600 mg/day. In a Chinese study, three possible clozapine UMs (all male smokers) were identified. The clozapine minimum therapeutic dose estimated with trough steady-state concentrations >150 ng/ml was: 1) 625 mg/day, based on a mean of 20 concentrations in Case 3; 2) 673 mg/day, based on a mean of 4 concentrations in Case 4; and 3) 648 mg/day, based on a mean of 11 concentrations in Case 5. Based on these limited studies, clozapine UMs during weak induction may account for 1-2% of clozapine-treated patients of European ancestry and <1% of those of Asian ancestry. A clozapine-to-norclozapine ratio <0.5 should not be used to identify clozapine UMs.
dc.language.isoENen_US
dc.title.enClozapine ultrarapid metabolism during weak induction probably exists but requires careful diagnosis. A literature review, five new cases and a proposed definition
dc.title.alternativeSchizophr Resen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/j.schres.2023.05.010en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed37268453en_US
bordeaux.journalSchizophrenia Researchen_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamAHEADen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.import.sourcepubmed
hal.identifierhal-04220135
hal.version1
hal.date.transferred2023-09-27T14:22:11Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
workflow.import.sourcepubmed
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&amp;rft_val_fmt=info:ofi/fmt:kev:mtx:journal&amp;rft.jtitle=Schizophrenia%20Research&amp;rft.date=2023-06-01&amp;rft.eissn=1573-2509&amp;rft.issn=1573-2509&amp;rft.au=SCHORETSANITIS,%20Georgios&amp;ANIL%20YA%C4%9ECIO%C4%9ELU,%20A%20Elif&amp;RUAN,%20Can-Jun&amp;EAP,%20Chin%20B&amp;MOLDEN,%20Espen&amp;rft.genre=article


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