Abstract
A significant barrier to realization of the full potential of clozapine as a therapeutic agent in the treatment of schizophrenia is the substantial interpatient variability that exists along the therapeutic continuum of no response–efficacious response–adverse response. Genetic polymorphisms that manifest as highly variable pharmacodynamic and pharmacokinetic measures are its expected causes. To support investigations that seek to understand these causes, the plasma and central nervous system pharmacokinetics of clozapine were determined in rats, the latter using microdialysis sampling. Results obtained with clozapine and N-desmethylclozapine, a pharmacologically active human metabolite that was administered to a separate group of animals, support a conclusion of net carrier-mediated efflux of both compounds across the blood-brain barrier. These results are supported by the replication of published findings regarding the passive transport and net efflux transport of two model compounds, escitalopram and risperidone, respectively. The results obtained with clozapine and N-desmethylclozapine are considered a first step in the development of preclinical pharmacokinetic-pharmacodynamic models that will support deeper mechanistic studies of clozapine in in vivo pharmacology, as well as the development of translational models that augment pharmacogenetic investigations that seek to improve the safety and efficacy of clozapine therapeutic intervention in the treatment of schizophrenia.
Footnotes
This work was sponsored by Brains On-Line (South San Francisco, CA).
Article, publication date, and citation information can be found at http://dmd.aspetjournals.org.
ABBREVIATIONS:
- PK
- pharmacokinetic(s)
- PD
- pharmacodynamic(s)
- CNS
- central nervous system
- BBB
- blood-brain barrier
- Pgp
- P-glycoprotein
- BCRP
- breast cancer resistance protein
- ECF
- extracellular fluid
- MS/MS
- tandem mass spectrometry
- AUC0-∞
- area under the concentration-time curve from zero to infinity
- KO
- knockout
- MDR
- multidrug resistance.
- Received March 12, 2012.
- Accepted June 26, 2012.
- Copyright © 2012 by The American Society for Pharmacology and Experimental Therapeutics
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