Evidence mapPaperPMID 41209151Full record

ArticleDrug design, development and therapy2025

Drug-Drug Interactions and Individualized Clozapine Therapy in Patients with Depression: Insights from Real-World Data.

Lei Jiang, Yue Zhang, Jie Wang, Cun Zhang, Dongdong Wang

Abstract read
In one paragraph

Article in Drug design, development and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Lei JiangDepartment of Pharmacy, Taixing Clinical College of Xuzhou Medical University, Taixing, Jiangsu, 225400, People's Republic of China.
Yue ZhangJiangsu Key Laboratory of New Drug Research and Clinical Pharmacy & School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, People's Republic of China.
Jie WangJiangsu Key Laboratory of New Drug Research and Clinical Pharmacy & School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, People's Republic of China.
Cun ZhangDepartment of Pharmacy, Xuzhou Oriental Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu, 221004, People's Republic of China.
Dongdong WangJiangsu Key Laboratory of New Drug Research and Clinical Pharmacy & School of Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, People's Republic of China.ORCID 0000-0002-4019-5530

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Clozapine is widely used in patients with depression but its metabolism via multiple hepatic enzymes raises concerns about drug-drug interactions (DDIs). The extent of these interactions in real-world clinical settings remains unclear. Methods: This research involved 29 patients with depression from the real world, utilizing their clozapine concentration data, physiological and biochemical data, and drug combination data to construct a DDI evaluation model using the population pharmacokinetics (PPK) method and NONMEM software. Results: The results of our research reveal that fluvoxamine maleate has a noteworthy DDI with clozapine, and fluvoxamine reduced clozapine clearance by 56.5%, necessitating substantial dose reductions. Furthermore, clozapine doses of 9 mg/kg, 8 mg/kg, 7 mg/kg and 6 mg/kg are recommended for 40-47 kg, 47-70 kg, 70-100 kg and 100-120 kg patients with depression not takingw fluvoxamine maleate, respectively. Clozapine doses of 3 mg/kg and 2 mg/kg are recommended for 40-70 kg and 70-120 kg patients with depression taking fluvoxamine maleate, respectively. Conclusion: This study provides the first real-world evidence to guide safe and individualized clozapine dosing in patients with depression, particularly in the context of fluvoxamine co-administration. When patients with depression patient are treated with fluvoxamine maleate, the dosage of clozapine needs to be reduced.

Indexed as

Antipsychotic AgentsClozapineDepressionFluvoxamineAdultAgedDose-Response Relationship, DrugDrug InteractionsFemaleHumansMaleMiddle AgedPrecision MedicineAntipsychotic AgentsClozapineFluvoxamineclozapinedepressiondrug–drug interactionsindividualized therapyreal-world

Identifiers

PMID41209151
PMCPMC12595923

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.