Clozapine-associated elevation of plasma cholinesterase.
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.


CONCLUSIONS
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.
Wiltfang
J
J
Department of Psychiatry and Psychotherapy, Göttingen, Germany. jwiltfa@gwdg.de
Schenk-Daprá
B
B
Stiens
G
G
Bleich
S
S
Bandelow
B
B
Müller
P
P
Niedmann
P D
PD
Armstrong
V W
VW
Rüther
E
E
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000097:blood; D015992:Body Mass Index; D001835:Body Weight; D002784:Cholesterol / Q000097:blood; D002802:Cholinesterases / Q000097:blood*; D003024:Clozapine / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000097:blood; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011618:Psychotic Disorders / Q000097:blood / Q000188:drug therapy; D012189:Retrospective Studies; D014280:Triglycerides / Q000097:blood
D014150:Antipsychotic Agents; D014280:Triglycerides; C058272:norclozapine; D002784:Cholesterol; D002802:Cholinesterases; D003024:Clozapine