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Clozapine-associated elevation of plasma cholinesterase
J Wiltfang1, B Schenk-Daprá, G Stiens
1Department of Psychiatry and Psychotherapy, Göttingen, Germany. jwiltfa@gwdg.de
Objective:
The goal of this study was to identify adverse effects of the atypical neuroleptic clozapine on liver function and lipid metabolism.
Methods:
Data which included serum levels of clozapine and its hepatic metabolite N-desmethyl clozapine were collected from medical records of patients treated with clozapine and controls.
Results:
We identified a clozapine-associated marked elevation of plasma cholinesterase (ChE) with unchanged levels of AST, ALT or g-GT. ChE was correlated to the serum level of clozapine and even closer to N-desmethyl clozapine. For the total patient group we observed significant correlations of ChE with the body-mass index and body weight. However, clozapine-treated patients and controls did not differ with regard to body-mass index, triglycerides, and cholesterol.
Conclusion:
We report for the first time a clozapine-associated and dose-dependent elevation of plasma ChE, which may be related to clozapine-associated effects on hepatic lipid metabolism or ChE enzyme induction.