Prognostic factors of therapeutic efficacy of clozapine in schizophrenia (literature review)

Abstract

This review of the literature is devoted to the analysis of predictors and markers of the therapeutic effect of clozapine, a powerful dibenzodiazepine antipsychotic with a wide profile of receptor activity and a pronounced anti-resistant effect. A systematic analysis of the English-language scientific literature was carried out, a number of clinical-demographic, pharmacokinetic, neurochemical and genetic parameters were considered with the assignment of evidence categories to them. Several indicators were found that were significantly associated with the therapeutic efficacy of clozapine: initially high severity of psychopathological symptoms and high premorbid
level of social functioning (positive predictors), tobacco smoking (negative predictor), plasma clozapine concentration > 350 ng/ml (positive marker), low baseline ratio of plasma concentrations of homovanillic acid / 5-hydroxyindoleacetic acid (positive predictor), age >65 years (negative predictor) predictor).