Psychopharmacology: Atypical Antipsychotic Dosing: The Effect of Smoking and Caffeine

The width of the therapeutic window determines the clinical
significance of the plasma level changes associated with smoking
and caffeine intake. Compared with olanzapine, clozapine has a
much narrower therapeutic window. Several of clozapine’s side effects
are dose related: plasma levels higher than 1,000 ng per milliliter
have been associated with toxicity, including seizure risk and severe
sedation. …

Continue reading

Clozaril Side Effects & Drug Interactions Associated with Discontinuation of Treatment

Clozapine is a substrate for many CYP450 isozymes, in particular 1A2, 2D6, and
3A4. The risk of metabolic interactions caused by an effect on an individual
isoform is therefore minimized. Nevertheless, caution should be used in patients
receiving concomitant treatment with other drugs that are either inhibitors or
inducers of these enzymes. …

Continue reading

PHARMACOGENOMICS: The Inherited Basis for Interindividual Differences in Drug Response

It is well recognized that most medications exhibit wide interpatient
variability in their efficacy and toxicity. For many medications, these
interindividual differences are due in part to polymorphisms in genes encoding
drug metabolizing enzymes, drug transporters, and/or drug targets (e.g.,
receptors, enzymes). …

Continue reading