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The Significance of Deviation in Time From the 12-hour Standard Serum-clozapine Monitoring.

Phase 4
Completed
Conditions
Schizophrenia
Interventions
Procedure: Blood sampling
Registration Number
NCT02625103
Lead Sponsor
Anders Fink-Jensen, MD, DMSci
Brief Summary

The role of Therapeutic Drug Monitoring (TDM) in clozapine dose adjustment have been debated. Blood samples for s-clozapine monitoring should be drawn 12 hours post dose.

The scope of this trial is to describe changes of s-clozapine and s-N-desmethyl-clozapine within the range of 10-14 hours after the last administration of clozapine .

Detailed Description

Several factors can influence s-clozapine and thereby the occurence of dose-related adverse reactions and level of treatment response. The role of Therapeutic Drug Monitoring (TDM) in clozapine dose adjustment have been debated. Blood samples for s-clozapine monitoring are recommended to be drawn 12 hours post dose. Uncertainty regarding the timing of blood sampling and the individual pharmakokinetics for clozapine +/- 2 hours from the 12-hour timepoint, leads to uncertainty regarding the comparability of serum concentrations and the information hold within them.

The scope of this trial is to describe changes of s-clozapine and s-N-desmethyl-clozapine within the range of 10-14 hours after the last administration of clozapine .

In addition we want to investigate if any of the following covariates might affect the change of s-clozapine and s-N-desmethyl-clozapine: Sex, age, BMI, co-medications, signs of infection, caffeine intake and smoking.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
48
Inclusion Criteria
  • Age 18 < 65
  • Diagnosed with schizophrenia according to the criteria of ICD10 (International Classification of Diseases, World Health Organization) or the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, the American Psychiatric Association)
  • Unchanged dose of clozapine for the last 30 days
  • Usual time of clozapine evening-dose administration between 9 and 12 pm.
Exclusion Criteria
  • Significant drug or alcohol abuse that affects participation in this trial
  • Non- or partial compliance of clozapine the day before the trial (assessed by interview)
  • Unresponsive by telephone the evening before the trial
  • Consumption of clozapine in the morning on the day of the trial
  • Significant change in smoking habits within the last 30 days (assessed by interview)
  • Significant change of caffeine intake within the last 7 days (assessed by interview)
  • Modified use of other antipsychotics within the last 30 days
  • Within the last 30 days (7 days for hormone based contraceptives) changes in the use of other medications that can affect s- clozapine during the trial : ( fluvoxamine, ciprofloxacin, hormone based contraceptives, carbamazepine , phenytoin , rifampicin, omeprazole )
  • Females who are pregnant or breast-feeding

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
ClozapineClozapinetreatment as usual: administration of clozapine between 9 and 12 pm. Blood sampling 10 -14 hours post drug administration
ClozapineBlood samplingtreatment as usual: administration of clozapine between 9 and 12 pm. Blood sampling 10 -14 hours post drug administration
Primary Outcome Measures
NameTimeMethod
Percentage change in serum-clozapine10 - 14 hours post drug administration
Secondary Outcome Measures
NameTimeMethod
Percentage change in serum-clozapine (multiple shorter ranges)< 10 -14 hours post dose

Trial Locations

Locations (1)

Psychiatric Centre Rigshospitalet

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Copenhagen, København Ø, Denmark

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