Abstract
Background Polypharmacy including somatic medications such as proton pump inhibitors is a common phenomenon in psychiatric care. The aim of this study was to evaluate the pantoprazole effects on clozapine metabolism. Methods A large therapeutic drug-monitoring database containing plasma concentrations of CLZ was analyzed. The results were stratified into four groups: a non-smoking (n = 250) and a ...
Abstract
Background Polypharmacy including somatic medications such as proton pump inhibitors is a common phenomenon in psychiatric care. The aim of this study was to evaluate the pantoprazole effects on clozapine metabolism. Methods A large therapeutic drug-monitoring database containing plasma concentrations of CLZ was analyzed. The results were stratified into four groups: a non-smoking (n = 250) and a smoking group (n = 326), and two groups co-medicated with pantoprazole: non-smokers ( n = 26) and smokers (n = 29). The analysis was based on the non-parametrical Mann-Whitney U test (M-W-U) with a significance level of 0.05. Results Differences reached statistical significance for pharmacokinetic parameters between CLZ monotherapy and comedication with pantoprazole neither in smokers nor in nonsmokers (p > 0.05 for M-W-U in pairwise comparisons). In patients with clozapine monotherapy, smokers had a higher daily dosage of CLZ compared to non-smokers (mean dosage 363 +/- 181 vs. 291 +/- 145 mg/day, p < 0.001 for M-W-U). Conclusions Adding pantoprazole to an ongoing treatment with clozapine does not alter the metabolism of clozapine to a significant extent.
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