ArticleJournal of neural transmission (Vienna, Austria : 1996)2016
Relationship between clozapine dose, serum concentration, and clinical outcome in children and adolescents in clinical practice.
Article in Journal of neural transmission (Vienna, Austria : 1996), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed.
- Serum concentrations of selective serotonin reuptake inhibitors and atypical antipsychotics in children and adolescents: data from routine clinical care.Journal of neural transmission (Vienna, Austria : 1996) · 2026Article
- Sex-Specific Differences in Antidepressant and Antipsychotic Treatment Outcomes and Serum Levels in Children and Adolescents.Pharmaceutics · 2025Article
- Clozapine-associated adverse drug reactions in 38,349 psychiatric inpatients: drug surveillance data from the AMSP project between 1993 and 2016.Journal of neural transmission (Vienna, Austria : 1996) · 2024Observational
- Therapeutic Drug Monitoring in Psychiatry: Enhancing Treatment Precision and Patient Outcomes.Pharmaceuticals (Basel, Switzerland) · 2024Review
- Association of clozapine and norclozapine levels with patient and therapy characteristics-focus on interaction with valproic acid.European journal of clinical pharmacology · 2023Article
- Serious Adverse Drug Reactions to Antipsychotics in Minors with Multiple Disabilities: Preventability and Potential Cost Savings by Therapeutic Drug Monitoring.Pharmacopsychiatry · 2023Article
- Therapeutic drug monitoring of atomoxetine in children and adolescents with attention-deficit/ hyperactivity disorder: a naturalistic study.Journal of neural transmission (Vienna, Austria : 1996) · 2022Article
- Factors predicting serum clozapine levels in Middle Eastern patients: an observational study.BMC psychiatry · 2022Observational
- A Rational Use of Clozapine Based on Adverse Drug Reactions, Pharmacokinetics, and Clinical Pharmacopsychology.Psychotherapy and psychosomatics · 2020Review
- Clinical Pharmacokinetics of Atypical Antipsychotics: An Update.Clinical pharmacokinetics · 2018Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Information on dose- and concentration-related clinical effects of clozapine treatment in children and adolescents is scarce. This study aimed to examine the relationship between dose, serum concentration, and clinical outcome as well as the influencing factors thereof in paediatric patients treated with clozapine. Data from a routine Therapeutic Drug Monitoring (TDM) service between 2004 and 2014 were studied in 68 patients, aged 11-18 years. Severity of illness, therapeutic effectiveness and adverse drug reactions (ADRs) were assessed by standardized means. A relationship between the daily dose (mean 319 mg, 4.9 mg/kg) and serum concentration (mean 387 ng/ml) of clozapine was found with the variation in dose explaining 30 % of the variability in clozapine serum concentrations. Also gender contributed to the variability, however, no influence of age or concomitant medications was detected. Furthermore, a significant association was found between clozapine serum concentration and the occurrence of ADRs. Patients without ADRs had a lower mean serum concentration than those with mild (261.4 vs 407.3 ng/ml, P = 0.018) and moderate ADRs (261.4 vs 416.3 ng/ml, P = 0.028). As clozapine was estimated to be effective in lower blood concentrations, guidance on a possibly lower therapeutic range of clozapine serum levels in paediatric patients is provided. With ADRs increasing under higher concentrations, TDM is strongly recommended in paediatric clozapine therapy for individualized dosing. Dose adjustment in females also might be reasonable according to gender-related differences in serum concentrations. However, regarding the limitations of this study results should be validated in larger studies with more standardized designs.
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