19
Views
5
CrossRef citations to date
0
Altmetric
Original Article

The clinical use of plasma clozapine levels

, , &
Pages 567-574 | Received 17 Sep 1997, Accepted 06 Apr 1998, Published online: 06 Jul 2009
 

Abstract

Objective: This review examines the evidence supporting the proposition that a threshold clozapine plasma level can predict clinical response. In addition, it provides a brief overview of the pharmacokinetics, side effects, drug interactions and assay methodology of clozapine.

Method: A comprehensive search of relevant literature was made with respect to the above criteria. The findings were collated and analysed to produce an overview of the usefulness of using clozapine levels in clinical practice. Results: Most researchers find that, although the correlation between dose of cloza pine and clinical effect is not high, a threshold plasma level of 350–420 ng mL of clozapine is associated with an increased probability of a good clinical response to the drug. Results vary, however, with the study design.

Conclusions: The data reviewed present a case for increasing the dose of cloz apine in non-responsive patients to achieve a plasma level of at least 350–420 ng mL−1. Non-response at these levels, however, should not preclude a further upward titration of dose. This should occur unless (i) clinical response is obtained at a lower dose, (ii) intolerable side effects occur, or (iii) a daily dose of 900 mg is reached.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.