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- Title
Role of cytokine changes in clozapine-induced fever: A cohort prospective study.
- Authors
Hung, Yuan‐Pin; Wang, Carol S‐M.; Yen, Chia‐Nan; Chang, Hsun‐Cheng; Chen, Po See; Lee, I Hui; Chen, Kao Chin; Yang, Yen Kuang; Lu, Ru‐Band; Wang, Tzu‐Yun
- Abstract
Aim Clozapine-associated fever is common but the specific cytokine changes and treatment durations that may cause fever remain unknown. We investigated the association between inflammatory cytokine changes and clozapine-induced fever in patients who were treated with clozapine. Methods Forty-three patients with schizophrenia or schizoaffective disorder, diagnosed by using the Chinese Version of the Mini International Neuropsychiatric Interview, were treated with clozapine for the first time (first-time use group, n = 22) or for more than 6 months (long-term use group, n = 21). The Positive and Negative Syndrome Scale, tympanic temperature, and levels of tumor necrosis factor-α ( TNF-α), interferon-γ ( INF-γ), interleukin-2 ( IL-2), and interleukin-6 ( IL-6) were determined at baseline and weeks 1, 2, 3, 4, and 6. A multiple linear regression with generalized estimating equation methods was used to analyze the association between the changes in the cytokine levels and clozapine-induced fever in the different groups. Results The IL-6 level changes were significantly different between the two groups ( P = 0.04). In the first-time use group, the fever rate was increased (47.1%) compared with the long-term use group (5.6%, P = 0.005). Moreover, in these patients, the TNF-α, INF-γ, IL-2, and IL-6 levels were significantly ( P < 0.001) different from patients who did not develop a fever. An interaction effect with the different treatment duration groups and fever development was only significant for IL-6 ( P < 0.001). Conclusion Patients who were treated with clozapine for the first time have an increased rate of developing a fever, and IL-6 might have a specific role in the interaction effect between treatment duration and fever development.
- Subjects
CLOZAPINE; FEVER; DRUG side effects; CYTOKINES; PEOPLE with schizophrenia; IMMUNOREGULATION
- Publication
Psychiatry & Clinical Neurosciences, 2017, Vol 71, Issue 6, p395
- ISSN
1323-1316
- Publication type
Article
- DOI
10.1111/pcn.12508