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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/10243


    Title: Role of cytokine changes in clozapine-induced fever: A cohort prospective study
    Authors: Hung, YP;Wang, CS;Yen, CN;Chang, HC;Chen, PS;Lee, IH;Chen, KC;Yang, YK;Lu, RB;Wang, TY
    Contributors: Center for Neuropsychiatric Research
    Abstract: AIM: Clozapine-associated fever is common but the specific cytokine changes and treatment durations that may cause fever remain unknown. We investigate 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 more than 6 months (long-term use group, n = 21). The Positive and Negative Syndrome Scale (PANSS), tympanic temperature, and levels of tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (INF-gamma), 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 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-alpha, INF-gamma, 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.
    Date: 2017-06
    Relation: Psychiatry and Clinical Neurosciences. 2017 Jun;71(6):395-402.
    Link to: http://dx.doi.org/10.1111/pcn.12508
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1323-1316&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000402889200005
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85015165265
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