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KMID : 0605620060130030152
Journal of Korean Society of Biological Psychiatry
2006 Volume.13 No. 3 p.152 ~ p.161
Plasma Concentrations of Clozapine and its Metabolites and FMO3 Variations in Korean Schizophrenic Patients
Lee Kyung-Hoon

Kim Chul-Eung
Abstract
Objectives:The relationship between the total daily dose of clozapine given and the plasma concentrations of clozapine and its metabolites(N-desmethylclozapine and clozapine N-oxide) and the effect of Glu158Lys (wild-type: Glu, ¡¯H¡¯ ; variant: Lys, ¡¯h¡¯) and Glu308Gly(wild-type: Glu, ¡¯D¡¯ ; variant: Lys, ¡¯d¡¯) variation in FMO3 gene on plasma concentrations of clozapine and its metabolites was studied in schizophrenic patients.

Methods:Trough plasma concentrations of clozapine and its metabolites were measured in 34 schizophrenic patients receiving clozapine. The genetic variation of ¡¯h¡¯ and ¡¯d¡¯ in FMO3 were analyzed in 21 among 34 patients.

Results:A linear relationship between the total daily dose of clozapine given(mg/kg body weight per day) and the plasma concentrations(nM) of clozapine was revealed by regression analysis(p<0.001) in the 23 patients receiving a constant daily dose of clozapine for 8 days. The plasma molar concentration ratios of clozapine N-oxide/clozapine in 8 subjects with ¡¯hh¡¯ or ¡¯Hh¡¯ alleles were not different from those in 6 subjects with ¡¯HH¡¯ alleles and the plasma molar concentration ratios in 6 subjects with ¡¯dd¡¯ or ¡¯Dd¡¯ alleles were not different from those in 8 subjects with ¡¯DD¡¯ alleles.

Conclusions:The effect of Glu158Lys and Glu308Gly variation in FMO3 gene on clozapine metabolism could not be shown.
KEYWORD
Clozapine, Clozapine N-oxide, Flavin-containing monooxygenase 3(FMO3), Genetic variation, Schizophrenia
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