title: Factors associated with subjective side-effects during clozapine treatment.
abstract: OBJECTIVE
  Clozapine is associated with subjectively unpleasant or clinically serious side-effects, which may affect treatment adherence. The aims of the study were to explore the association of clozapine+ norclozapine serum concentration and other factors with subjective side-effects in schizophrenia patients.
  
  
  METHODS
  In this cross-sectional study, 237 patients with a diagnosis of schizophrenia, schizo-affective or other non-organic psychoses completed the Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS), a self-report scale measuring side-effects of antipsychotics and a clinical questionnaire. Clozapine+ norclozapine serum concentration of 190 patients was measured. Of the patients 80 (33.7%) were on antipsychotic combination therapy.
  
  
  RESULTS
  Higher clozapine+ norclozapine concentrations were associated with the depression-anxiety factor of LUNSERS and antipsychotic combination treatments were associated with sympatichotonia-tension factor. Younger patients reported sedation more often than older patients.
  
  
  CONCLUSIONS
  According to the present results, high clozapine concentrations were associated with depression-anxiety symptoms, but the causality remains unknown.
authors.affiliation: Niko Seppälä, Department of Psychiatry, Satakunta Hospital District, University of Tampere , FI-29200 Harjavalta , and Medical School, Faculty of Medicine, University of Tampere , FI-33140 Tampere , Finland.
authors.forename: Niko
authors.initials: N
authors.lastname: Seppälä
authors.forename: Esa
authors.initials: E
authors.lastname: Leinonen
authors.forename: Merja
authors.initials: M
authors.lastname: Viikki
authors.forename: Anssi
authors.initials: A
authors.lastname: Solismaa
authors.forename: Timo
authors.initials: T
authors.lastname: Nuolivirta
authors.forename: Olli
authors.initials: O
authors.lastname: Kampman
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000097:blood / Q000627:therapeutic use*; D001007:Anxiety / Q000453:epidemiology*; D015984:Causality; D003024:Clozapine / Q000031:analogs & derivatives / Q000097:blood / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011618:Psychotic Disorders / Q000188:drug therapy; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy; D057566:Self Report; D012894:Sleep Stages; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; C058272:norclozapine; D003024:Clozapine
keywords: Adverse events; Antipsychotic agents; Clozapine; LUNSERS; Schizophrenia; Treatment adherence