ArticlePsychopharmacology2016
Inflammation and psychotropic drugs: the relationship between C-reactive protein and antipsychotic drug levels.
Article in Psychopharmacology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 82 citations in OpenAlex.
- The Cytokine Release Syndrome and/or the Proinflammatory Cytokines as Underlying Mechanisms of Downregulation of Drug Metabolism and Drug Transport: A Systematic Review of the Clinical Pharmacokinetics of Victim Drugs of this Drug-Disease Interaction Under Different Clinical Conditions.Clinical pharmacokinetics · 2022Pooled it
- Elevated acute phase proteins affect pharmacokinetics in COVID-19 trials: Lessons from the CounterCOVID - imatinib study.CPT: pharmacometrics & systems pharmacology · 2021Trial
- CYP1A2 expression and activity in a large panel of human nonneoplastic surgical liver samples: Influence of genetics, lifestyle, and other factors.Drug metabolism and disposition: the biological fate of chemicals · 2025Article
- Identifying factors related to sertraline concentrations in child/adolescent and adult patients: insights from a therapeutic drug monitoring service.BMC psychiatry · 2025Article
- Acute inflammation induced by the Escherichia coli lipopolysaccharide considerably increases the systemic and brain exposure of olanzapine after oral administration in mice.The international journal of neuropsychopharmacology · 2025Article
- Managing ciprofloxacin-clozapine interaction with immunoassay-based monitoring: A case report.The mental health clinician · 2025Article
- Review
- Increased antipsychotic drug concentration in hospitalized patients with mental disorders following COVID-19 infection: a call for attention.Frontiers in psychiatry · 2024Article
- Association of clozapine and norclozapine levels with patient and therapy characteristics-focus on interaction with valproic acid.European journal of clinical pharmacology · 2023Article
- C-Reactive Protein: Pathophysiology, Diagnosis, False Test Results and a Novel Diagnostic Algorithm for Clinicians.Diseases (Basel, Switzerland) · 2023Review
- Inflammatory markers in outpatients with schizophrenia diagnosis in regular use of clozapine: a cross-sectional study.Frontiers in psychiatry · 2023Article
- Pharmacokinetics of Haloperidol in Critically Ill Patients: Is There an Association with Inflammation?Pharmaceutics · 2022Article
- Is Vitamin B12 Level a Reliable Predictor of Psychosis Severity in Male Patients with Megaloblastic Anemia at a Single Tertiary Hospital?International journal of general medicine · 2022Article
- E-Cigarette Use, Systemic Inflammation, and Depression.International journal of environmental research and public health · 2021Article
- Inflammation Induces Changes in the Functional Expression of P-gp, BCRP, and MRP2: An Overview of Different Models and Consequences for Drug Disposition.Pharmaceutics · 2021Review
- Selective Serotonin Reuptake Inhibitors and Clozapine: Clinically Relevant Interactions and Considerations.Neurology international · 2021Review
- Therapeutic Drug Monitoring of Second- and Third-Generation Antipsychotic Drugs-Influence of Smoking Behavior and Inflammation on Pharmacokinetics.Pharmaceuticals (Basel, Switzerland) · 2021Review
- The Influence of Pharmacogenetics on the Clinical Relevance of Pharmacokinetic Drug-Drug Interactions: Drug-Gene, Drug-Gene-Gene and Drug-Drug-Gene Interactions.Pharmaceuticals (Basel, Switzerland) · 2021Review
- Clozapine intoxication with severe adverse effects induced by an inflammatory and infectious process: a case report.Journal of medical case reports · 2021Article
- Relationship Between Curative Effect and Serum Inflammatory Factors Level in Male Patients With First-Episode Schizophrenia Treated With Olanzapine.Frontiers in psychiatry · 2021Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationaleIn psychiatric clinical practice, there is a need to identify psychotropic drugs whose metabolisms are prone to be altered with increased inflammatory activity in an individual patient.
objectivesThe aim of this study was to find out whether elevated serum levels (≥5 mg/l) of C-reactive protein (CRP), an established laboratory marker of infection and inflammation, are associated with increased serum concentrations of the atypical antipsychotic drugs clozapine, quetiapine, and risperidone.
methodsTherapeutic drug monitoring request forms of patients whose antipsychotic drug concentrations had been measured under conditions of normal (<5 mg/l) and pathological (>5 mg/l) levels of C-reactive protein were retrospectively screened. The serum concentrations in relation to the daily doses [concentration per dose (C/D) (ng/mL/mg)] and the metabolic ratios [ratio of concentrations (metabolite/drug)] were compared intraindividually by the Wilcoxon signed rank test. To the study effects of the intensity of infections on drug concentrations, C-reactive protein and C/D levels were submitted to Spearman's correlation analysis.
resultsElevated levels of C-reactive protein were found in 105 patients. They were significantly associated with elevated values in C/D for clozapine (n = 33, P < 0.01) and risperidone (n = 40, P < 0.01). A trend for an increase was found for quetiapine (n = 32, P = 0.05). Median increases were 48.0 % (clozapine), 11.9 % (quetiapine), and 24.2 % (active moiety of risperidone), respectively.
conclusionsIn patients who exhibit signs of inflammation or infection with increased C-reactive protein values during psychopharmacological treatment, especially under clozapine and risperidone, therapeutic drug monitoring is recommendable in order to minimize the risk of intoxications due to elevated drug concentrations.
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