Effects of Sex Differences and Combined Use of Clozapine on Initial Dosage Optimization of Valproic Acid in Patients with Bipolar Disorder


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Abstract

Background:Due to the narrow therapeutic window and large pharmacokinetic variation of valproic acid (VPA), it is difficult to make an optimal dosage regimen. The present study aims to optimize the initial dosage of VPA in patients with bipolar disorder.

Methods:A total of 126 patients with bipolar disorder treated by VPA were included to construct the VPA population pharmacokinetic model retrospectively. Sex differences and combined use of clozapine were found to significantly affect VPA clearance in patients with bipolar disorder. The initial dosage of VPA was further optimized in male patients without the combined use of clozapine, female patients without the combined use of clozapine, male patients with the combined use of clozapine, and female patients with the combined use of clozapine, respectively.

Results:The CL/F and V/F of VPA in patients with bipolar disorder were 11.3 L/h and 36.4 L, respectively. It was found that sex differences and combined use of clozapine significantly affected VPA clearance in patients with bipolar disorder. At the same weight, the VPA clearance rates were 1.134, 1, 1.276884, and 1.126 in male patients without the combined use of clozapine, female patients without the combined use of clozapine, male patients with the combined use of clozapine, and female patients with the combined use of clozapine, respectively. This study further optimized the initial dosage of VPA in male patients without the combined use of clozapine, female patients without the combined use of clozapine, male patients with the combined use of clozapine, and female patients with the combined use of clozapine, respectively.

Conclusion:This study is the first to investigate the initial dosage optimization of VPA in patients with bipolar disorder based on sex differences and the combined use of clozapine. Male patients had higher clearance, and the recommended initial dose decreased with increasing weight, providing a reference for the precision drug use of VPA in clinical patients with bipolar disorder.

About the authors

Wei Shen

Department of Pharmacy, The Suqian Clinical College of Xuzhou Medical University

Email: info@benthamscience.net

Ke Hu

Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy & School of Pharmacy, Xuzhou Medical University

Email: info@benthamscience.net

Hao-Zhe Shi

Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy & School of Pharmacy, Xuzhou Medical University

Email: info@benthamscience.net

Lei Jiang

Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy & School of Pharmacy, Xuzhou Medical University

Email: info@benthamscience.net

Yi-Jia Zhang

Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy & School of Pharmacy, Xuzhou Medical University

Email: info@benthamscience.net

Su-Mei He

Department of Pharmacy, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University

Author for correspondence.
Email: info@benthamscience.net

Cun Zhang

Department of Pharmacy, Xuzhou Oriental Hospital Affiliated to Xuzhou Medical University

Author for correspondence.
Email: info@benthamscience.net

Xiao Chen

School of Nursing, Xuzhou Medical University

Author for correspondence.
Email: info@benthamscience.net

Dong-Dong Wang

Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy & School of Pharmacy, Xuzhou Medical University

Author for correspondence.
Email: info@benthamscience.net

References

  1. Carvalho AF, Firth J, Vieta E. Bipolar disorder. N Engl J Med 2020; 383(1): 58-66. doi: 10.1056/NEJMra1906193 PMID: 32609982
  2. McIntyre RS, Berk M, Brietzke E, et al. Bipolar disorders. Lancet 2020; 396(10265): 1841-56. doi: 10.1016/S0140-6736(20)31544-0 PMID: 33278937
  3. Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. Lancet Psychiatry 2016; 3(2): 171-8. doi: 10.1016/S2215-0366(15)00505-2 PMID: 26851330
  4. Rantala MJ, Luoto S, Borráz-León JI, Krams I. Bipolar disorder: An evolutionary psychoneuroimmunological approach. Neurosci Biobehav Rev 2021; 122: 28-37. doi: 10.1016/j.neubiorev.2020.12.031 PMID: 33421542
  5. Haggarty SJ, Karmacharya R, Perlis RH. Advances toward precision medicine for bipolar disorder: Mechanisms & molecules. Mol Psychiatry 2021; 26(1): 168-85. doi: 10.1038/s41380-020-0831-4 PMID: 32636474
  6. Vieta E, Berk M, Schulze TG, et al. Bipolar disorders. Nat Rev Dis Primers 2018; 4(1): 18008. doi: 10.1038/nrdp.2018.8 PMID: 29516993
  7. Fontana E, Mandolini GM, Delvecchio G, Bressi C, Soares JC, Brambilla P. Intravenous valproate in the treatment of acute manic episode in bipolar disorder: A review. J Affect Disord 2020; 260: 738-43. doi: 10.1016/j.jad.2019.08.071 PMID: 31581039
  8. Pisanu C, Heilbronner U, Squassina A. The role of pharmacogenomics in bipolar disorder: Moving towards precision medicine. Mol Diagn Ther 2018; 22(4): 409-20. doi: 10.1007/s40291-018-0335-y PMID: 29790107
  9. Cipriani A, Reid K, Young AH, Macritchie K, Geddes J. Valproic acid, valproate and divalproex in the maintenance treatment of bipolar disorder. Cochrane Libr 2013; 2013(10): CD003196. doi: 10.1002/14651858.CD003196.pub2 PMID: 24132760
  10. Arnbjerg CJ, Musoni-Rwililiza E, Rurangwa NU, et al. Effectiveness of structured group psychoeducation for people with bipolar disorder in Rwanda: A randomized open-label superiority trial. J Affect Disord 2024; 356: 405-13. doi: 10.1016/j.jad.2024.04.071 PMID: 38640974
  11. Azevedo J, Swales M, Carreiras D, Guiomar R, Macedo A, Castilho P. BI-REAL: A 12-session DBT skills group intervention adapted for bipolar disorder – A feasibility randomised pilot trial. J Affect Disord 2024; 356: 394-404. doi: 10.1016/j.jad.2024.04.033 PMID: 38615843
  12. Chen PH, Hsiao CY, Chiang SJ, Chung KH, Tsai SY. Association of lipids and inflammatory markers with left ventricular wall thickness in patients with bipolar disorder. J Affect Disord 2024; 358: 12-8. doi: 10.1016/j.jad.2024.05.020 PMID: 38705523
  13. Chen Z, Wang B, Huang Y, Wang X, Li W, Wang M. Pathogenesis or a response to lithium? A novel perspective for mitochondrial mass fluctuation of naïve T cells in patients with bipolar disorder. J Affect Disord 2024; 355: 86-94. doi: 10.1016/j.jad.2024.03.095 PMID: 38521135
  14. Holm M, Tanskanen A, Tiihonen J, Taipale H. Medication use and sickness absence from work in bipolar disorder: A nationwide register-based study. World Psychiatry 2024; 23(2): 296-8. doi: 10.1002/wps.21213 PMID: 38727041
  15. Karaca A, Şener DK, Kundakçi N. Being a child of a parent with a diagnosis of schizophrenia or bipolar disorder: A qualitative study. Arch Psychiatr Nurs 2024; 50: 94-9. doi: 10.1016/j.apnu.2024.03.011 PMID: 38789240
  16. Klaus F, Ng HX, Barbosa IG, et al. Cognition in older age bipolar disorder: An analysis of archival data across the globe. J Affect Disord 2024; 355: 231-8. doi: 10.1016/j.jad.2024.03.126 PMID: 38548199
  17. Knorr U, Simonsen AH, Nilsson J, et al. Cerebrospinal fluid synaptic biomarker changes in bipolar disorder – A longitudinal case-control study. J Affect Disord 2024; 358: 250-9. doi: 10.1016/j.jad.2024.05.034 PMID: 38723679
  18. Lane E, Joshi D, Guimond S, et al. Exploring current smartphone-based cognitive assessments in schizophrenia and bipolar disorder. Schizophr Res Cogn 2024; 37: 100309. doi: 10.1016/j.scog.2024.100309 PMID: 38550527
  19. Musoni-Rwililiza E, Arnbjerg CJ, Rurangwa NU, et al. Adaption and validation of the Rwandese version of the Mood Disorder Questionnaire for the screening of bipolar disorder. Compr Psychiatry 2024; 132: 152477. doi: 10.1016/j.comppsych.2024.152477 PMID: 38583298
  20. Porta-Casteràs D, Vicent-Gil M, Serra-Blasco M, et al. Increased grey matter volumes in the temporal lobe and its relationship with cognitive functioning in euthymic patients with bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry 2024; 132: 110962. doi: 10.1016/j.pnpbp.2024.110962 PMID: 38365103
  21. Stacey D, Suppiah V, Benyamin B, Lee SH, Hyppönen E. In-silico functional analyses identify TMPRSS15-mediated intestinal absorption of lithium as a modulator of lithium response in bipolar disorder. J Affect Disord 2024; 358: 416-21. doi: 10.1016/j.jad.2024.05.050 PMID: 38735581
  22. Teng Z, Xu X, Chen X, et al. Increased circulating cell-free mitochondrial DNA in plasma of first-diagnosed drug-naïve bipolar disorder patients: A case-control and 4-week follow-up study. J Affect Disord 2024; 355: 378-84. doi: 10.1016/j.jad.2024.03.113 PMID: 38537754
  23. Wang T, Yang J, Zhu Y, et al. Evaluation of metabolomics-based urinary biomarker models for recognizing major depression disorder and bipolar disorder. J Affect Disord 2024; 356: 1-12. doi: 10.1016/j.jad.2024.03.114 PMID: 38548210
  24. Zhou Z, Xu Z, Lai W, et al. Reduced myelin content in bipolar disorder: A study of inhomogeneous magnetization transfer. J Affect Disord 2024; 356: 363-70. doi: 10.1016/j.jad.2024.04.012 PMID: 38615848
  25. Chen Z, Huang Y, Wang B, et al. T cells: An emerging cast of roles in bipolar disorder. Transl Psychiatry 2023; 13(1): 153. doi: 10.1038/s41398-023-02445-y PMID: 37156764
  26. Perucca E. Pharmacological and therapeutic properties of valproate: A summary after 35 years of clinical experience. CNS Drugs 2002; 16(10): 695-714. doi: 10.2165/00023210-200216100-00004 PMID: 12269862
  27. Bowden CL, Karren NU. Anticonvulsants in bipolar disorder. Aust N Z J Psychiatry 2006; 40(5): 386-93. doi: 10.1080/j.1440-1614.2006.01815.x PMID: 16683963
  28. Chateauvieux S, Morceau F, Dicato M. Molecular and therapeutic potential and toxicity of valproic acid. J Biomed Biotechnol 2010; 2010: 479364. doi: 10.1155/2010/479364 PMID: 20798865
  29. Zheng P, Yu Z, Mo L, et al. An individualized medication model of sodium valproate for patients with bipolar disorder based on machine learning and deep learning techniques. Front Pharmacol 2022; 13: 890221. doi: 10.3389/fphar.2022.890221 PMID: 36339624
  30. Thase ME. Maintenance therapy for bipolar disorder. J Clin Psychiatry 2008; 69(11): e32. doi: 10.4088/JCP.1108e32 PMID: 19200424
  31. Revicki DA, Hirschfeld RMA, Ahearn EP, Weisler RH, Palmer C, Keck PE Jr. Effectiveness and medical costs of divalproex versus lithium in the treatment of bipolar disorder: Results of a naturalistic clinical trial. J Affect Disord 2005; 86(2-3): 183-93. doi: 10.1016/j.jad.2005.01.002 PMID: 15935238
  32. Chen YCB, Liang CS, Wang LJ, et al. Comparative effectiveness of valproic acid in different serum concentrations for maintenance treatment of bipolar disorder: A retrospective cohort study using target trial emulation framework. EClinicalMedicine 2022; 54: 101678. doi: 10.1016/j.eclinm.2022.101678 PMID: 36193173
  33. Fleming J, Chetty M. Therapeutic monitoring of valproate in psychiatry: How far have we progressed? Clin Neuropharmacol 2006; 29(6): 350-60. doi: 10.1097/01.WNF.0000228209.69524.E8 PMID: 17095899
  34. Methaneethorn J. A systematic review of population pharmacokinetics of valproic acid. Br J Clin Pharmacol 2018; 84(5): 816-34. doi: 10.1111/bcp.13510 PMID: 29328514
  35. Gidal B, Spencer N, Maly M, et al. Valproate-mediated disturbances of hemostasis. Neurology 1994; 44(8): 1418-22. doi: 10.1212/WNL.44.8.1418 PMID: 8058141
  36. Teixeira-da-Silva P, Pérez-Blanco JS, Santos-Buelga D, Otero MJ, García MJ. Population pharmacokinetics of valproic acid in pediatric and adult caucasian patients. Pharmaceutics 2022; 14(4): 811. doi: 10.3390/pharmaceutics14040811 PMID: 35456645
  37. Zang YN, Guo W, Niu MX, et al. Population pharmacokinetics of valproic acid in adult Chinese patients with bipolar disorder. Eur J Clin Pharmacol 2022; 78(3): 405-18. doi: 10.1007/s00228-021-03246-2 PMID: 34854947
  38. Gu X, Zhu M, Sheng C, et al. Population pharmacokinetics of unbound valproic acid in pediatric epilepsy patients in China: A protein binding model. Eur J Clin Pharmacol 2021; 77(7): 999-1009. doi: 10.1007/s00228-020-03080-y PMID: 33423079
  39. El Orche A, Cheikh A, Johnson JB, et al. A novel approach for therapeutic drug monitoring of valproic acid using FT-IR spectroscopy and nonlinear support vector regression. J AOAC Int 2023; 106(4): 1070-6. doi: 10.1093/jaoacint/qsac146 PMID: 36367248
  40. Hunt MF, Clark KT, Grant MC, et al. Therapeutic drug monitoring of valproic acid in extracorporeal membrane oxygenation. Perfusion 2021; 36(8): 868-72. doi: 10.1177/0267659120972272 PMID: 33198577
  41. Li R, Chen Z, Tang S, et al. Association of valproic acid and its main metabolites’ plasma concentrations with clinical outcomes among epilepsy patients: A 10-year retrospective study based on therapeutic drug monitoring. Drug Metab Dispos 2024; 52(3): 210-7. doi: 10.1124/dmd.123.001539 PMID: 38195521
  42. Li Y, Jiang Y, Cao H, et al. Therapeutic drug monitoring of valproic acid using a dried plasma spot sampling device. J Mass Spectrom 2021; 56(4): e4603. doi: 10.1002/jms.4603 PMID: 33729629
  43. Shaikh AS, Liu H, Li Y, Cao L, Guo R. Therapeutic drug monitoring of valproic acid. Pak J Pharm Sci 2018; 31(4(Special)): 1773-6. PMID: 30203778
  44. Singu BS, Morrison H, Irengeya L, Verbeeck RK. Therapeutic drug monitoring of phenytoin and valproic acid in critically ill patients at Windhoek Central Hospital, Namibia. Afr J Lab Med 2022; 11(1): 1628. doi: 10.4102/ajlm.v11i1.1628 PMID: 35937763
  45. Ahmed K, Ibrahim A, Gonzalez D, Nur A. Population pharmacokinetics and model-based dose optimization of vancomycin in sudanese adult patients with renal impairment. Drug Des Devel Ther 2024; 18: 81-95. doi: 10.2147/DDDT.S432439 PMID: 38260090
  46. Bulitta JB, Fang E, Stryjewski ME, et al. Population pharmacokinetic rationale for intravenous contezolid acefosamil followed by oral contezolid dosage regimens. Antimicrob Agents Chemother 2024; 68(4): e01400-23. doi: 10.1128/aac.01400-23 PMID: 38415667
  47. Feng H, Wang X, Zheng W, et al. Initial dosage optimisation of cyclosporine in Chinese paediatric patients undergoing allogeneic haematopoietic stem cell transplantation based on population pharmacokinetics: A retrospective study. BMJ Paediatr Open 2023; 7(1): e002003. doi: 10.1136/bmjpo-2023-002003 PMID: 37643815
  48. Han HH, Rui M, Yang Y, et al. The impact of spironolactone co-administration on cyclosporin initial dosage optimization for pediatric refractory nephrotic syndrome. Curr Pharm Des 2024; 30(18): 1419-32. doi: 10.2174/0113816128307797240416053723 PMID: 38639271
  49. Jing Y, Kong Y, Hou X, et al. Population pharmacokinetic analysis and dosing guidelines for tacrolimus co-administration with Wuzhi capsule in Chinese renal transplant recipients. J Clin Pharm Ther 2021; 46(4): 1117-28. doi: 10.1111/jcpt.13407 PMID: 33768546
  50. Li X, Cheng Y, Chen B, et al. Population pharmacokinetics of polymyxin B in patients with liver dysfunction. Br J Clin Pharmacol 2023; 89(12): 3561-72. doi: 10.1111/bcp.15855 PMID: 37461291
  51. Lim CP, Tseng SH, Neoh CCC, Chen Q, Poon WB. External validation of a vancomycin population pharmacokinetic model and developing a new dosage regimen in neonates. Eur J Drug Metab Pharmacokinet 2022; 47(5): 687-97. doi: 10.1007/s13318-022-00781-w PMID: 35804218
  52. Shimamoto Y, Verstegen RHJ, Mizuno T, Schechter T, Allen U, Ito S. Population pharmacokinetics of vancomycin in paediatric patients with febrile neutropenia and augmented renal clearance: Development of new dosing recommendations. J Antimicrob Chemother 2021; 76(11): 2932-40. doi: 10.1093/jac/dkab302 PMID: 34480578
  53. Wang C, Chen J, Yang B, et al. Determination of vancomycin exposure target and individualized dosing recommendations for critically ill patients undergoing continuous renal replacement therapy. Pharmacotherapy 2023; 43(3): 180-8. doi: 10.1002/phar.2771 PMID: 36714991
  54. Zhu X, Zhang M, Wen Y, Shang D. Machine learning advances the integration of covariates in population pharmacokinetic models: Valproic acid as an example. Front Pharmacol 2022; 13: 994665. doi: 10.3389/fphar.2022.994665 PMID: 36324679
  55. Egelund EF, Isaza R, Brock AP, Alsultan A, An G, Peloquin CA. Population pharmacokinetics of rifampin in the treatment of Mycobacterium tuberculosis in Asian elephants. J Vet Pharmacol Ther 2015; 38(2): 137-43. doi: 10.1111/jvp.12156 PMID: 25236765
  56. Eley VA, Christensen R, Ryan R, et al. Prophylactic cefazolin dosing in women with body mass index >35 kg·m-2 undergoing cesarean delivery: A pharmacokinetic study of plasma and interstitial fluid. Anesth Analg 2020; 131(1): 199-207. doi: 10.1213/ANE.0000000000004766 PMID: 32250982
  57. Fredj NB, Romdhane HB, Woillard JB, et al. Population pharmacokinetic model of isoniazid in patients with tuberculosis in Tunisia. Int J Infect Dis 2021; 104: 562-7. doi: 10.1016/j.ijid.2021.01.033 PMID: 33476758
  58. Kim TH, Shin S, Bulitta JB, Youn YS, Yoo SD, Shin BS. Development of a physiologically relevant population pharmacokinetic in vitro – in vivo correlation approach for designing extended-release oral dosage formulation. Mol Pharm 2017; 14(1): 53-65. doi: 10.1021/acs.molpharmaceut.6b00677 PMID: 27809538
  59. Li Z, Liu Y, Jiao Z, et al. Population pharmacokinetics of vancomycin in chinese ICU neonates: Initial dosage recommendations. Front Pharmacol 2018; 9: 603. doi: 10.3389/fphar.2018.00603 PMID: 29997498
  60. Liu Y, Qiu T, Liu Y, et al. Model-based voriconazole dose pptimization in Chinese adult patients with hematologic malignancies. Clin Ther 2019; 41(6): 1151-63. doi: 10.1016/j.clinthera.2019.04.027 PMID: 31079860
  61. Mehta K, Ravimohan S, Pasipanodya JG, et al. Optimizing ethambutol dosing among HIV/tuberculosis co-infected patients: A population pharmacokinetic modelling and simulation study. J Antimicrob Chemother 2019; 74(10): 2994-3002. doi: 10.1093/jac/dkz265 PMID: 31273386
  62. Milliken E, de Zwart AES, Alffenaar JWC, et al. Population pharmacokinetics of ribavirin in lung transplant recipients and examination of current and alternative dosing regimens. J Antimicrob Chemother 2019; 74(3): 691-8. doi: 10.1093/jac/dky466 PMID: 30452661
  63. Ramon-Lopez A, Allen JM, Thomson AH, et al. Dosing regimen of meropenem for adults with severe burns: A population pharmacokinetic study with Monte Carlo simulations. J Antimicrob Chemother 2015; 70(3): 882-90. doi: 10.1093/jac/dku429 PMID: 25362574
  64. Rao Q, Yang Y, Wang S, et al. Optimal dosing regimen of biapenem based on population pharmacokinetic/pharmacodynamic modelling and Monte Carlo simulation in patients with febrile neutropenia and haematological malignancies. Int J Antimicrob Agents 2023; 62(1): 106841. doi: 10.1016/j.ijantimicag.2023.106841 PMID: 37160241
  65. Liao M, Wang M, Zhu X, Zhao L, Zhao M. Tacrolimus population pharmacokinetic model in adult Chinese patients with nephrotic syndrome and dosing regimen identification using monte carlo simulations. Ther Drug Monit 2022; 44(5): 615-24. doi: 10.1097/FTD.0000000000001008 PMID: 36101928
  66. Xu H, Zhou W, Zhou D, Li J, Al-Huniti N. Evaluation of aztreonam dosing regimens in patients with normal and impaired renal function: A population pharmacokinetic modeling and monte carlo simulation analysis. J Clin Pharmacol 2017; 57(3): 336-44. doi: 10.1002/jcph.810 PMID: 27530649
  67. Anderson BJ, Holford NHG. Mechanism-based concepts of size and maturity in pharmacokinetics. Annu Rev Pharmacol Toxicol 2008; 48(1): 303-32. doi: 10.1146/annurev.pharmtox.48.113006.094708 PMID: 17914927
  68. Hiemke C, Bergemann N, Clement HW. Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: Update 2017. Pharmacopsychiatry 2017; 51(1-2): 9-62.
  69. Yatham LN, Kennedy SH, Parikh SV, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord 2018; 20(2): 97-170. doi: 10.1111/bdi.12609 PMID: 29536616
  70. Atmaca M. Valproate and neuroprotective effects for bipolar disorder. Int Rev Psychiatry 2009; 21(4): 410-3. doi: 10.1080/09540260902962206 PMID: 20374154
  71. Zang YN, Guo W, Dong F, Li AN, de Leon J, Ruan CJ. Published population pharmacokinetic models of valproic acid in adult patients: A systematic review and external validation in a Chinese sample of inpatients with bipolar disorder. Expert Rev Clin Pharmacol 2022; 15(5): 621-35. doi: 10.1080/17512433.2022.2075849 PMID: 35536685
  72. Bazinet RP, Weis MT, Rapoport SI, Rosenberger TA. Valproic acid selectively inhibits conversion of arachidonic acid to arachidonoyl–CoA by brain microsomal long-chain fatty acyl–CoA synthetases: relevance to bipolar disorder. Psychopharmacology (Berl) 2006; 184(1): 122-9. doi: 10.1007/s00213-005-0272-4 PMID: 16344985
  73. Methaneethorn J, Leelakanok N. Predictive ability of published population pharmacokinetic models of valproic acid in Thai manic patients. J Clin Pharm Ther 2021; 46(1): 198-207. doi: 10.1111/jcpt.13280 PMID: 32986889
  74. Jiang DC, Wang L. Population pharmacokinetic model of valproate and prediction of valproate serum concentrations in children with epilepsy. Acta Pharmacol Sin 2004; 25(12): 1576-83. PMID: 15569400
  75. Correa T, Rodríguez I, Romano S. Population pharmacokinetics of valproate in Mexican children with epilepsy. Biopharm Drug Dispos 2008; 29(9): 511-20. doi: 10.1002/bdd.636 PMID: 19067436
  76. Park HM, Kang SS, Lee YB, et al. Population pharmacokinetics of intravenous valproic acid in Korean patients. J Clin Pharm Ther 2002; 27(6): 419-25. doi: 10.1046/j.1365-2710.2002.00440.x PMID: 12472981
  77. Jiao Z, Li XG, Sheng DW, et al. Model informed precision dosing: China expert consensus report. Chin J. Clin Pharmacol Ther 2021; 26(11): 1215-28.
  78. Tabrisi R, Harun-Rashid MD, Montero J. Clozapine but not lithium reverses aberrant tyrosine uptake in patients with bipolar disorder. Psychopharmacology 2023; 240(8): 1667-76. doi: 10.1007/s00213-023-06397-5
  79. Loo LWJ, Chew QH, Lin SK. Clozapine use for bipolar disorder: An asian psychotropic prescription patterns consortium study. J Clin Psychopharmacol 2023; 43(3): 278-82.
  80. Wilkowska A, Wiglusz MS, Cubała WJ. Clozapine in treatment-resistant bipolar disorder with suicidality. Three case reports. Front Psychiatry 2019; 10: 520. doi: 10.3389/fpsyt.2019.00520 PMID: 31379632
  81. Delgado A, Velosa J, Zhang J, Dursun SM, Kapczinski F, de Azevedo Cardoso T. Clozapine in bipolar disorder: A systematic review and meta-analysis. J Psychiatr Res 2020; 125: 21-7. doi: 10.1016/j.jpsychires.2020.02.026 PMID: 32182485
  82. Forte A, Pompili M, Imbastaro B, et al. Effects on suicidal risk: Comparison of clozapine to other newer medicines indicated to treat schizophrenia or bipolar disorder. J Psychopharmacol 2021; 35(9): 1074-80. doi: 10.1177/02698811211029738 PMID: 34291676
  83. Danek PJ, Basińska-Ziobroń A, Wójcikowski J, Daniel WA. Levomepromazine and clozapine induce the main human cytochrome P450 drug metabolizing enzyme CYP3A4. Pharmacol Rep 2021; 73(1): 303-8. doi: 10.1007/s43440-020-00157-4 PMID: 32888176

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