Clozapine and global cognition in schizophrenia

Journal of Clinical Psychopharmacology
Tarek K RajjiBenoit H Mulsant

Abstract

Clozapine (CLZ) has been shown to have a beneficial effect on cognition in schizophrenia in some studies and a detrimental effect in others. The relative effect and exposure to CLZ and its major metabolite-N-desmethylclozapine (NDMC)-could explain these discrepancies. Using a validated measure of global cognition, we performed 2 binary logistic regression models to assess the relationship among cognition, age, sex, CLZ dose, CLZ and NDMC plasma levels, and their ratio (CLZ/NDMC) in individuals with schizophrenia spectrum disorders. Model 1 included age, sex, CLZ dose, and CLZ and NDMC levels. Model 2 included age, sex, CLZ dose, and CLZ/NDMC. Among 73 subjects (mean [SD] age, 41.6 [12.0] years), 16 (21.9%) had high cognitive impairment, whereas the rest had low cognitive. In model 1, age and CLZ level were associated with high cognitive impairment (odds ratio [95% confidence interval] for age, 1.079 [1.011-1.152]; CLZ level, 1.010 [1.003-1.017]), whereas NDMC level was associated with its absence (NDMC level, 0.987 [0.977-0.997]). In model 2, age, male sex, and CLZ/NDMC were associated with cognitive impairment (age, 1.083 [1.015-1.154]; sex, 0.178 [0.032-0.994]; CLZ/NDMC, 7.302 [1.823-29.253]). Clozapine dose was not associate...Continue Reading

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Citations

Jun 4, 2011·Expert Opinion on Drug Safety·Philip Gerretsen, Bruce G Pollock
Mar 23, 2011·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Zahinoor IsmailRobert R Bies
May 4, 2011·Acta Psychiatrica Scandinavica·J NielsenD Taylor
Sep 4, 2015·Journal of Clinical and Experimental Neuropsychology·Rachel BattySusan Rossell
Jul 19, 2012·Expert Opinion on Pharmacotherapy·Eric Fakra, Jean-Michel Azorin

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