Related Experiment Video
Updated: Aug 8, 2026
05:52
Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis
Published on: November 21, 2013
Predictors of response to clozapine
J A Lieberman1, J M Kane, A Z Safferman
1Department of Psychiatry, Albert Einstein College of Medicine Hillside Hospital, Division of Long Island Jewish Medical Center, Glen Oaks, N.Y. 11004.
The Journal of Clinical Psychiatry
|September 1, 1994
Summary
Predicting clozapine response in schizophrenia is possible using clinical and biological markers. Factors like male gender, illness subtype, and specific neurochemical responses indicate therapeutic success.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Clozapine is an effective antipsychotic for treatment-resistant schizophrenia.
- Predictors of clozapine response remain incompletely understood.
- Identifying reliable biomarkers can optimize treatment strategies.
Purpose of the Study:
- To investigate the relationship between clinical and biological measures and clinical response to clozapine.
- To identify potential predictors of therapeutic efficacy for clozapine treatment.
Main Methods:
- Correlational analysis of clinical and biological variables with clozapine response.
- Assessment of pretreatment factors including demographics, illness characteristics, cerebrospinal fluid (CSF) metabolites, and endocrine responses to apomorphine.
- Monitoring of plasma clozapine levels during treatment.
Main Results:
- Male gender, paranoid schizophrenia subtype, older age at onset, and shorter illness duration were associated with better response.
- Higher pretreatment acute extrapyramidal symptoms (EPS) and low CSF homovanillic acid/5-hydroxyindoleacetic acid (HVA/5-HIAA) ratios correlated with therapeutic success.
- Greater reduction in prolactin (PRL) and increase in growth hormone (GH) response to apomorphine pretreatment, and enhanced inhibition of these hormones by clozapine, predicted response.
- Plasma clozapine levels exceeding 350 ng/mL were linked to therapeutic outcomes.
Conclusions:
- Clinical and biological markers can predict clozapine response in schizophrenia.
- These findings support the utility of specific biomarkers for guiding clozapine therapy.
- Understanding these associations offers insights into clozapine's mechanism of action.
Related Concept Videos
01:21Factors Affecting Drug Response: Overview
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
01:28Psychosis and Antipsychotic Drugs: Overview
The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic symptoms in all...
01:26Psychosis: Goals of Pharmacotherapy
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation. For...
01:21Antipsychotic Drugs: Typical and Atypical Agents
Antipsychotic drugs are classified into first-generation (typical) drugs including phenothiazines; and second-generation (atypical) drugs. Chlorpromazine hydrochloride (Thorazine), a phenothiazine derivative, broadly impacts the central, autonomic, and endocrine systems. This drug, along with typical agents like haloperidol (Haldol), primarily works by antagonizing D2 receptors, thus reducing dopaminergic neurotransmission. However, typical antipsychotics can cause side effects such as sedation...
01:29Psychological and Sociocultural Causes of Schizophrenia
Schizophrenia, a complex psychiatric disorder, has been historically misunderstood. Early psychological theories attributed its origins to childhood trauma and unresponsive parenting. However, contemporary research largely rejects these notions, favoring the vulnerability-stress hypothesis. This model proposes that individuals with a genetic predisposition to schizophrenia may develop the disorder following exposure to significant environmental stressors. Notably, studies on high-risk...
01:28Drug Therapy
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications