Pharmacokinetic interactions between clozapine and valproic acid in patients with treatment-resistant schizophrenia: Does UGT polymorphism affect these drug interactions?

The combination of valproic acid (VPA) and clozapine (CLZ) is regularly prescribed for augmentation therapy in treatment resistant schizophrenia. The VPA has been shown to reduce norclozapine (NCLZ) plasma levels, but the mechanism of this interaction remains unknown. The aim of this study is to examine the differences between patients treated with CLZ and patients treated with CLZ plus VPA.

Exploring the usefulness of plasma level determination and pharmacogenetics for patients treated with clozapine.

The aims of the present study were to assess the variance of plasma clozapine (CLZ) levels and to identify the influence of sociodemographic and pharmacogenetic factors on it and to introduce these tools in a clinical setting. CLZ concentration was measured and genetic variants of CLZ pharmacokinetic and pharmacodynamic factors were assessed in 23 patients with psychotic disorders. A significant association between mean concentration/dose ratio (C/D) and smoking status, age and weight were found.

Merging intraoral scans and CBCT: a novel technique for improving the accuracy of 3D digital models for implant-supported complete-arch fixed dental prostheses.

Aim: A technique for merging digital intraoral and CBCT scans for implant-supported complete-arch fixed dental prostheses (FDPs) is described. The aim is to improve the dimensional accuracy of intraoral scans in edentulous arches.

Materials And Method: Two files are recorded: an intraoral scan and a CBCT scan, both obtained with scan bodies connected to the implants in the same position.

Deep brain stimulation in treatment resistant schizophrenia: A pilot randomized cross-over clinical trial.

Background: Up to 30% of patients with schizophrenia are resistant to antipsychotic drug treatment, with 60% of such cases also failing to respond to clozapine. Deep brain stimulation (DBS) has been used in treatment resistant patients with other psychiatric disorders, but there is a lack of trials in schizophrenia, partly due to uncertainties over where to site the electrodes. This trial aimed to examine the effectiveness of nucleus accumbens (NAcc) and subgenual anterior cingulate cortex (subgenual ACC) targeted DBS; the primary outcome measure was PANSS total score, as assessed fortnightly.

Implementation of pharmacogenetics in a clozapine treatment resistant patient: a case report.

We report the case of a young Caucasian male with disorganized chronic schizophrenia, an active smoker and nonresponder to 400 mg of clozapine/day. Therapeutic clozapine monitoring was analyzed revealing a low clozapine:norclozapine ratio. An additional pharmacogenetic test was carried out showing that the patient carried variant ( gene), which has been associated with nonresponse to clozapine in smoker patients.

The linguistic signature of hallucinated voice talk in schizophrenia.

Very few studies have investigated the formal linguistic aspects of auditory verbal hallucinations (AVHs), though speech is a defining aspect of AVHs. Hallucinated speech heard by 19 patients with schizophrenia and highly frequent voices was obtained online, as and when they spoke, and annotated for pre-selected linguistic variables. Results showed that, consistently across the sample, (i) the grammatical first Person was significantly less represented than both second and third person, and often absent altogether; (ii) overwhelmingly, isolated clauses with no grammatical connectivity (parataxis) were produced, as compared with subordinations, coordinations, and adjunctions; (iii) in all participants except one, virtually no noun phrases (NPs) were anaphoric ones, back-referring to previous NPs, illustrating again a lack of connectivity across utterances.