Clozapine: clinical doses adjusted to sideeffects and clinical effect
Study summary
The outline of the current project is to establish a cohort of patients with treatment refractory schizophrenia eligible for clozapine, to identify clinical and biological characteristics of clozapine responding patients. Patients will be offered treatment with clozapine according to national clinical guidelines. Before clozapine is initiated, patients will be offered a thoroughly neurobiological examination, and re-examination will be carried out after 12 weeks of treatment. The primary focus of the examinations will be immunological markers and autoantibodies in the blood and cerebrospinal fluid, permeability of the blood-brain barrier and magnetic resonance imaging of structural, neurochemical and functional brain changes.
Eligibility
Sex
ALL
Min age
18 Years
Max age
64 Years
Healthy volunteers
No
Inclusion Criteria:
* According to ICD-10 fulfill diagnostic criteria for schizophrenia (F20.x), chronical paranoid psychoses (F22), Schizoaffective psychoses (F25) or other non-organic psychoses (F28/F29);
* Age 18-65 years;
* Legally competent;
* Stabil antipsychotic treatment during last month
* Being treatment refractory according to TRIPP-guidelines (Howes et al. 2017) defined as having tried at least two antipsychotic drugs in sufficient dosage (≥600 mg chlorpromazine equivalent) for a sufficient time (≥ 6 weeks) without sufficient symptom improvement (still a moderate level of positive symptoms).
* Recreational use of substances is allowed as long as it does not interfere with compliance
* Fertile females must use safe contraception (spiral or any hormonal contraception).
Exclusion Criteria:
* Involuntarily psychiatric admittance during the study
* Substance abuse that interfere with compliance
* Pregnancy (will be verified by urine-HCG-test in fertile females)
* Toxic or idiosyncratic agranulocytosis in the past
* Reduced bone marrow function according to blood samples
* According to information from patient and available files, noUncontrolled
* Current uncontrolled epilepsy
* Current circulatory collapse and / or CNS depression for any cause
* Current severe kidney, heart or liver disease
* Current paralytic ileus
Primary outcome measure(s)
Qalb — Baseline Quotient albumin (Qabl) in cerebrospinal fluid (CSF) compared to plasma
Change in Qalb — Baseline and after 12 weeks Change in quotient albumin in cerebrospinal fluid compared to plasma
Change in IL-6 and TGF-beta — Baseline and after 12 weeks Change in interleukin 6 (IL-6) and transcription growth factor beta (TGF-beta)
Trial sites (1)
Facility
City
Region
Status
Mental Health Services Glostrup, Unit for Complicated Schizophrenia
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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