Clozapine Dose-Concentration Relationship and Other Factors Associated With Clozapine Plasma Concentration in Korean Schizophrenia Patients

Abstract

Objectives: Some reports suggest that the concentration-to-dosage ratio (C/D ratio) of clozapine (CZP) in Asian treatment-resistant schizophrenia (TRS) patients differs from that of Caucasian TRS patients. However, there is insufficient research on the differences in C/D ratio between Korean TRS patients and Caucasian TRS patients. Therefore, this study aimed to investigate prescribed CZP dosage, CZP concentration and C/D ratio in Korean TRS patients.Methods: The study included TRS patients aged 18 years or older who were prescribed CZP for at least 12 weeks at a psychiatric hospital in Korea. We collected demographic information, smoking status, hospitalization status, CZP serum concentration, total CZP dosage, and norclozapine (NCZP) serum concentration and analyzed their statistical correlations.Results: The study found that the average daily CZP dosage was 266.1 mg, and the average CZP concentration was 568.0 ng/mL. There was a significant correlation between CZP serum concentration and smoking status, as well as sex. CZP dosage was not significantly associated with age, weight, BMI, or metabolic rate. The study also found a significant difference in C/D ratio between groups based on CZP serum concentration.Conclusion: Our study suggests that recommended CZP dosages for Caucasians may not be suitable for Koreans due to C/D ratio differences. We found a relationship between CZP serum concentration and C/D ratio in Korean TRS patients. Therefore, it is crucial to confirm CZP serum concentration to avoid side effects and to find optimal dosage.