Clozapine Administration Potentiate Platelet Activation in Patients with Schizophrenia: Retrospective Study / 정신신체의학

ABSTRACT

OBJECTIVES: Clozapine is a widely prescribed antipsychotic drug for schizophrenia and is known to increase the risk of cardiovascular disease due to its metabolic side effects. However, little is known about the effect of clozapine on the platelet activation, another important factor in the development of cardiovascular disease. In this study, we tried to investigate the effect of clozapine on platelet activity in patients with schizophrenia by comparing the mean platelet component (MPC) values before and after the clozapine administration. METHODS: A retrospective review of medical records of patients with schizophrenia, who newly started clozapine treatment from September 1st, 2003 to April 30th, 2007 at the Department of Psychiatry, Konyang University Hospital in Republic of Korea was performed. The final statistical analysis included 14 participants. Bayer ADVIA 120® system was used to measure MPC. RESULTS: Among the 14 participants, five subjects were males (28.60%), and ten subjects were females (71.40%). The mean age of participants was 37.50±11.64 years. Average of duration of illness was 91.00±93.96 months, with the mean dosage of clozapine taken by participants at the time of the last blood test was 337.50±109.52 mg. The mean MPC measurement before and after receiving clozapine was 26.12±2.22 g/dL and 25.14±2.08 g/dL respectively. Wilcoxon signed rank test showed that there was a statistically significant decrease in MPC levels after clozapine administration (V=16, p=0.024). CONCLUSIONS: Decreased MPC levels after clozapine administration implies that clozapine may increase platelet activation which could have an adverse effect on the occurrence of thromboembolic disease. Our findings also suggest that careful monitoring of the risk factors of cardiovascular diseases, such as platelets activity, is necessary when administering clozapine.