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KMID : 1118520200170111158
Psychiatry Investigation
2020 Volume.17 No. 11 p.1158 ~ p.1165
Relationship of Change in Plasma Clozapine/N-desmethylclozapine Ratio with Cognitive Performance in Patients with Schizophrenia
Park Ro-Yun

Kim Seo-Young
Kim Eui-Tae
Abstract
Objective: The clozapine/N-desmethylclozapine (NDMC) ratio is proposed to be used as a predictor of cognitive performance in clozapine-treated patients, as its principal metabolite, NDMC, has an opposite action with clozapine on the cholinergic system. The aim of this study is to determine whether clozapine has influence on cognitive performance in accordance with changes in the clozapine/NDMC in patients with schizophrenia.

Methods: The data of fifteen patients with schizophrenia, who had initial and follow-up assessments after starting clozapine treatment, were retrospectively collected. The assessments included clinical scale, cognitive battery, and pharmacological data including plasma concentrations of clozapine and NDMC. The data were analyzed with Pearson correlation and stepwise multiple regression analyses.

Results: ¥ÄAttention/vigilance, ¥Äsocial cognition, and ¥Äcomposite score had a significant correlation with ¥Äclozapine/NDMC ratio, while ¥ÄWorking memory had correlation with ¥Äclozapine concentration and ¥ÄNDMC concentration, and ¥Äsocial cognition had association with ¥Äclozapine concentration. Multiple regression analysis showed that ¥Äattention/vigilance had negative association with ¥Äclozapine/NDMC ratio, ¥Äworking memory had negative relation with ¥Äclozapine concentration, and that ¥Äsocial cognition had negative association with ¥Äclozapine concentration.

Conclusion: This finding implicates that lowering the clozapine/NDMC ratio could enhance cognition in patients with schizophrenia treated with clozapine.
KEYWORD
Clozapine, Cognition, Attention, Schizophrenia
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