Bacterial pneumonia can increase serum concentration of clozapine.
Concentrations of serum clozapine, C-reactive protein (CRP) and alpha1 acid glycoprotein were greatly increased during a bacterial pneumonia in a 53-year-old woman. As the pneumonia subsided, and CRP and alpha1 acid glycoprotein normalised, serum clozapine concentration also decreased to the previous level. An increased serum clozapine and a lowered N-desmethylclozapine to clozapine ratio during the infection suggest a decreased cytochrome P(450) (CYP)1A2 activity. Cytokine-mediated CYP1A2 suppression is discussed.
Raaska
K
K
Department of Clinical Pharmacology, University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland. kari.raaska@hus.fi
Raitasuo
V
V
Arstila
M
M
Neuvonen
P J
PJ
D014150:Antipsychotic Agents / Q000097:blood* / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis; D003024:Clozapine / Q000097:blood* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D009961:Orosomucoid / Q000032:analysis; D018410:Pneumonia, Bacterial / Q000150:complications / Q000378:metabolism*; D012559:Schizophrenia / Q000150:complications / Q000378:metabolism*
D014150:Antipsychotic Agents; D009961:Orosomucoid; D002097:C-Reactive Protein; D003024:Clozapine