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Metabolic differences between Asian and Caucasian patients on clozapine treatment
Author(s) -
Subramaniam Mythily,
Ng Chee,
Chong SiowAnn,
Mahendran Rathi,
Lambert Tim,
Pek Elaine,
Huak Chan Yiong
Publication year - 2007
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/hup.842
Subject(s) - clozapine , medicine , body mass index , schizophrenia (object oriented programming) , gastroenterology , blood pressure , endocrinology , psychiatry
Abstract Objective To establish if there are ethnic differences in the various metabolic disturbances that are common with clozapine treatment. Method Forty subjects (20 Asians and 20 Caucasians) with a diagnosis of schizophrenia were recruited for the study. Clozapine blood levels as well as fasting blood glucose, lipid levels, and liver function tests were established. Other clinical parameters such as blood pressure and Body Mass Index (BMI) were recorded for each patient. Results The mean clozapine dose was significantly higher in the Caucasian subjects (432.5 ± 194.7 mg) as compared to the Asian subjects (175.6 ± 106.9 mg) ( p < 0.001) while the mean weight‐corrected dose for Asian patients was lower (3.0 ± 1.9 and 5.0 ± 2.1 mg/kg, respectively, p = 0.005). There were, however, no ethnic differences in the mean plasma clozapine concentration (415.3 ± 185.8 ng/ml in Caucasians and 417.1 ± 290.8 ng/ml in Asians). BMI were significantly higher in Caucasians, as were the number of subjects with hypertension; levels of hepatic enzymes were higher in the Asian group. Conclusions Not only are there pharmacokinetic differences between Asian and Caucasian patients receiving clozapine, but there may also be differential emergence of certain metabolic abnormalities like hypertension and weight gain in these two ethnic groups. However, the effects of life style including diet and exercise cannot be excluded. Copyright © 2007 John Wiley & Sons, Ltd.