Evidence map›Paper›PMID 41863380›Full record

ArticleSchizophrenia bulletin2026

The Impact of Sex and Age on Antipsychotic Serum Concentrations.

Franciska de Beer, Bodyl A Brand, Ben Wijnen, Shiral S Gangadin, Georgios Schoretsanitis, Daan Touw, Iris E C Sommer

Abstract read
In one paragraph

Article in Schizophrenia bulletin, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. The influence of sex on cognition in psychosis.Schizophrenia research. Cognition · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Franciska de BeerCenter for Clinical Neuroscience and Cognition, University Medical Center Groningen, University of Groningen, Groningen, 9713 AP, The Netherlands.ORCID 0000-0002-0740-0969
Bodyl A BrandDepartment of Psychiatry, University of Oxford, Oxford, OX3 7JX, United Kingdom.
Ben WijnenCentre of Economic Evaluations & Machine Learning, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, 3521 VS, The Netherlands.
Shiral S GangadinCenter for Clinical Neuroscience and Cognition, University Medical Center Groningen, University of Groningen, Groningen, 9713 AP, The Netherlands.ORCID 0000-0002-0084-8226
Georgios SchoretsanitisDepartment of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, 8008, Switzerland.
Daan TouwDepartment of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, 9713 GZ, The Netherlands.
Iris E C SommerCenter for Clinical Neuroscience and Cognition, University Medical Center Groningen, University of Groningen, Groningen, 9713 AP, The Netherlands.

Funding

Dutch Medical Science Foundation ZonMW 10140312310002
6 · The paper itself

Abstract

background and hypothesisEstrogen affects drug metabolism for specific antipsychotics, which may produce sex differences in serum levels, especially over the menopausal transition. Here, we explore sex differences in concentrations of four commonly used antipsychotics: clozapine, olanzapine, aripiprazole, and quetiapine and examined how these vary across age groups, including postmenopause (>55). STUDY

designAntipsychotic concentrations of 44 378 serum samples drawn between January 2016 and October 2024 were analyzed. Samples were provided by 6147 unique adult men and women for clozapine (n = 34 761 samples, 26% female), olanzapine (n = 5114, 27% female), aripiprazole (n = 3171, 37% female), and quetiapine (n = 1332, 50% female). To investigate the effect of sex and age on antipsychotic concentrations, we employed linear mixed-effects models and pairwise contrasts by dividing the samples in 6 groups according to sex and age (<45, 45-55, and >55 years). STUDY

resultsWe found higher concentrations in women compared to men for clozapine (P < .001), and olanzapine (P < .001), but not for quetiapine or aripiprazole. Young women (<45) showed higher levels of clozapine (P = .004) and olanzapine (P < .001) than men, but older women did not. Clozapine levels were higher in women <45 and 45-55 compared to women >55 years (all P < .05). For olanzapine, aripiprazole, and quetiapine concentrations differences between female age groups were absent.

conclusionsWe found sex differences in olanzapine and clozapine concentrations, which were most pronounced until 45 years of age. Our findings suggest that monitoring antipsychotic levels may add clinical value and underscore the need for sex-specific prescription guidelines for olanzapine and clozapine.

Indexed as

Antipsychotic AgentsAripiprazoleClozapineOlanzapineQuetiapine FumarateSchizophreniaSex CharacteristicsAdultAgedAge FactorsFemaleHumansMaleMiddle AgedSex FactorsYoung AdultAntipsychotic AgentsAripiprazoleClozapineOlanzapineQuetiapine Fumarateantipsychotic medicationmenopausepsychosissextherapeutic drug monitoring

Identifiers

PMID41863380
PMCPMC13005119

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.