title: [Therapeutic drug monitoring of clozapine].
abstract: Clozapine is a prototypical atypical antipsychotic used to treat severe schizophrenia and for which a therapeutic drug monitoring (TDM) is quite commonly proposed. Clozapine is rapidly absorbed (maximum concentration reached within 1 to 4hours), and is extensively metabolized in the liver by CYP1A2 to an active metabolite (and to a lesser extent, to inactive metabolites via other enzymes). Its half-life is 8 to 16h. A therapeutic range has been proposed for clozapine as some studies have reported both a relationship between low plasmatic concentrations and resistance to treatment (threshold level is likely between 250 and 400μg/L), and a relationship between high plasmatic concentrations and an increase in the occurrence of toxicity (alert level=1000μg/L). Given the data obtained in different studies, the TDM was evaluated for this molecule, to recommended.
authors: Laboratoire de pharmacologie médicale, CHU de Reims, 45, rue Cognac-Jay, 51092 Reims cedex, France. Electronic address: zdjerada@chu-reims.fr.
authors: Zoubir
authors: Z
authors: Djerada
authors: Centre hospitalier spécialisé Paul-Guiraud, 94800 Villejuif, France.
authors: Françoise
authors: F
authors: Daviet
authors: Service de psychiatrie de l'adulte B, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors: Pierre-Michel
authors: PM
authors: Llorca
authors: Service de pharmacologie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors: Alain
authors: A
authors: Eschalier
authors: Laboratoire de pharmacologie et toxicologie, CHU de Limoges, 87000 Limoges, France.
authors: Franck
authors: F
authors: Saint-Marcoux
authors: Laboratoire de pharmacologie biologique, CHU Pontchaillou, 35033 Rennes, France.
authors: Danièle
authors: D
authors: Bentué-Ferrer
authors: Service de pharmacologie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
authors: Fréderic
authors: F
authors: Libert
keywords: Clozapine; Level of evidence; Niveau de preuve; Suivi thérapeutique pharmacologique; Therapeutic drug monitoring