Clozapine-induced electroencephalogram changes as a function of clozapine serum levels

被引:79
作者
Freudenreich, O
Weiner, RD
McEvoy, JP
机构
[1] JOHN UMSTEAD HOSP,ADULT ADMISS UNIT,BUTNER,NC 27509
[2] DUKE UNIV,MED CTR,DURHAM,NC
[3] DURHAM VA MED CTR,DURHAM,NC
关键词
clozapine; seizures; electroencephalogram; schizophrenia; serum level;
D O I
10.1016/S0006-3223(96)00298-3
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Specific electroencephalogram (EEG) changes during clozapine therapy were prospectively studied in a cohort of 50 chronic state hospital patients with schizophrenia who were randomly assigned to one of three nonoverlapping clozapine serum level ranges (50-150 ng/mL, 200-300 ng/mL, and 350-450 ng/mL). EEGs were obtained before clozapine was instituted, and after 10 weeks of treatment. Fifty-three percent of patients showed EEG changes during the 10-week study period. We observed three seizures (6%), one in a patient on 900 mg (serum level 320 ng/mL) clozapine, and two in patients with lower clozapine serum levels (200-300 ng/mL) who had prior histories of seizures and inadequate valproate coverage. Thirteen percent of patients developed spikes with no relationship to dose or serum level of clozapine. Fifty-three percent developed slowing on EEG. Compared to plasma levels below 300 ng/mL, a clozapine serum level between 350 and 450 ng/mL led to more frequent and more severe slowing. The EEG slowing correlated with observed sleepiness, although this factor was not sufficient to explain the severity of high-dose effects. (C) 1997 Society of Biological Psychiatry.
引用
收藏
页码:132 / 137
页数:6
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