Korean J Psychosom Med.  2018 Dec;26(2):188-193. 10.22722/KJPM.2018.26.2.188.

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

• Kim HA
• Lee JW
• Kim SJ
• Oh HS
• Im WY
• Kim JW

• KMID: 2437571
• DOI: http://doi.org/10.22722/KJPM.2018.26.2.188

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.

Keyword

Clozapine; Mean platelet component; Platelet activation; Thromboembolic disease

MeSH Terms

Blood Platelets*
Cardiovascular Diseases
Clozapine*
Female
Hematologic Tests
Humans
Male
Medical Records
Platelet Activation*
Republic of Korea
Retrospective Studies*
Risk Factors
Schizophrenia*
Clozapine