Immunomodulatory effects of clozapine and their clinical implications: What have we learned so far?

摘要: Clozapine remains the drug of choice for treatment resistant schizophrenia, but is associated with potentially life threatening side effects, including agranulocytosis and myocarditis. Immunological mechanisms may be involved in development these effects or unique antipsychotic efficacy subgroups schizophrenia patients. This systematic review presents immunomodulatory clozapine from human vitro vivo studies relates findings to developments adverse therapeutic clozapine. Several confirm actions clozapine, only few investigated their relationship During first month treatment, up 50% patients develop fever flu like symptoms, which seemingly driven by increased cytokines. Within same time period, risk side-effects a suspected immunological mechanism peaks. Patients developing during weeks should have thorough physical examination, measurements white blood cell count, absolute neutrophil ECG, C-reactive protein, creatinine kinase, troponin exclude infection, agranulocytosis, myocarditis neuroleptic malignant syndrome. To what degree related its has not been studied. Research relating early markers clinically relevant outcomes hoped provide new leads understanding pathophysiology aid novel targets.