Psychosis Research Today is a free monthly online journal that collates and summarizes the latest research about Psychosis, including details on clinical depression, schizophrenia, bipolar disorder. | ||||||||
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Predictors and markers of clozapine response.Chung C, Remington G Centre for Addiction and Mental Health, Schizophrenia Program, 250 College Street, Toronto, Ontario, M5T 1R8, Canada. RATIONALE: With other atypical antipsychotics now available, having predictors of clozapine response would be of considerable value, offering clinicians guidance in their decision as to when, and if, a trial of clozapine is warranted. OBJECTIVES: The aim was to review existing evidence regarding identified predictors and markers of clozapine response. METHODS: Relevant studies were identified through PUBMED searches (1975-June 2004) and cross-referencing of reviews and included studies. The data were summarized under two main categories: clinical (general, neurological, cognitive/neuropsychological, clozapine levels) and biological (biochemical, endocrine, genetic, metabolic, morphological, dopamine D2 receptor occupancy). 'Reliable' predictors/markers were defined a priori as those with support of at least two independent reports that addressed overall response, with no contradictory findings to date. 'Potential' predictors/markers had the support of a single report that addressed overall response and at least one other evaluating treatment outcome but not directly addressing response status. RESULTS AND CONCLUSIONS: Higher baseline clinical symptoms and functioning in the previous years and low cerebrospinal homovanillic acid/5-hydroxyindoleacetic acid levels were identified as reliable. Three potential measures were identified: reduction of frontal cortex metabolic activity, reduction of caudate volume, and improvement in P50 sensory gating. Published 11 April 2005 in Psychopharmacology (Berl), 179(2): 317-35.
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