An International Adult Guideline for Making Clozapine Titration Safer by Using Six Ancestry-Based Personalized Dosing Titrations, CRP, and Clozapine Levels

Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt

Standard

An International Adult Guideline for Making Clozapine Titration Safer by Using Six Ancestry-Based Personalized Dosing Titrations, CRP, and Clozapine Levels. / de Leon, Jose; Schoretsanitis, Georgios; Smith, Robert L.; Molden, Espen; Solismaa, Anssi; Seppala, Niko; Kopecek, Miloslav; Svancer, Patrik; Olmos, Ismael; Ricciardi, Carina; Iglesias-Garcia, Celso; Iglesias-Alonso, Ana; Spina, Edoardo; Ruan, Can-Jun; Wang, Chuan-Yue; Wang, Gang; Tang, Yi-Lang; Lin, Shih-Ku; Lane, Hsien-Yuan; Kim, Yong Sik; Kim, Se Hyun; Rajkumar, Anto P.; Gonzalez-Esquivel, Dinora F.; Jung-Cook, Helgi; Baptista, Trino; Rohde, Christopher; Nielsen, Jimmi; Verdoux, Helene; Quiles, Clelia; Sanz, Emilio J.; De las Cuevas, Carlos; Cohen, Dan; Schulte, Peter F. J.; Ertugrul, Aygun; Chopra, Nitin; McCollum, Betsy; Shelton, Charles; Cotes, Robert O.; Kaithi, Arun R.; Kane, John M.; Farooq, Saeed; Ng, Chee H.; Bilbily, John; Hiemke, Christoph; Lopez-Jaramillo, Carlos; McGrane, Ian; Lana, Fernando; Eap, Chin B.; Arrojo-Romero, Manuel; Seifritz, Erich; Every-Palmer, Susanna; Bousman, Chad A.; Bebawi, Emmanuel; Bhattacharya, Rahul; Kelly, Deanna L.; Otsuka, Yuji; Lazary, Judit; Torres, Rafael; Yecora, Agustin; Motuca, Mariano; Chan, Sherry K. W.; Zolezzi, Monica; Ouanes, Sami; De Berardis, Domenico; Grover, Sandeep; Procyshyn, Ric M.; Adebayo, Richard A.; Kirilochev, Oleg O.; Soloviev, Andrey; Fountoulakis, Konstantinos N.; Wilkowska, Alina; Ayub, Muhammad; Silva, Alzira; Bonelli, Raphael M.; Villagran-Moreno, Jose M.; Crespo-Facorro, Benedicto; Temmingh, Henk; Decloedt, Eric; Pedro, Maria R.; Takeuchi, Hiroyoshi; Tsukahara, Masaru; Gruender, Gerhard; Sagud, Marina; Celofiga, Andreja; Ristic, Dragana Ignjatovic; Ortiz, Bruno B.; Elkis, Helio; Palha, Antonio J. Pacheco; LLerena, Adrian; Fernandez-Egea, Emilio; Siskind, Dan; Weizman, Abraham; Masmoudi, Rim; Saffian, Shamin Mohd; Leung, Jonathan G.; Buckley, Peter F.; Marder, Stephen R.; Citrome, Leslie; Freudenreich, Oliver; Correll, Christoph U.; Muller, Daniel J.; Anil Yagcioglu, A. Elif; Radulescu, Flavian S.; Cubala, Wieslaw J.

I: Pharmacopsychiatry, Bind 55, Nr. 02, 03.2022, s. 73-86.

Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt

Harvard

de Leon, J, Schoretsanitis, G, Smith, RL, Molden, E, Solismaa, A, Seppala, N, Kopecek, M, Svancer, P, Olmos, I, Ricciardi, C, Iglesias-Garcia, C, Iglesias-Alonso, A, Spina, E, Ruan, C-J, Wang, C-Y, Wang, G, Tang, Y-L, Lin, S-K, Lane, H-Y, Kim, YS, Kim, SH, Rajkumar, AP, Gonzalez-Esquivel, DF, Jung-Cook, H, Baptista, T, Rohde, C, Nielsen, J, Verdoux, H, Quiles, C, Sanz, EJ, De las Cuevas, C, Cohen, D, Schulte, PFJ, Ertugrul, A, Chopra, N, McCollum, B, Shelton, C, Cotes, RO, Kaithi, AR, Kane, JM, Farooq, S, Ng, CH, Bilbily, J, Hiemke, C, Lopez-Jaramillo, C, McGrane, I, Lana, F, Eap, CB, Arrojo-Romero, M, Seifritz, E, Every-Palmer, S, Bousman, CA, Bebawi, E, Bhattacharya, R, Kelly, DL, Otsuka, Y, Lazary, J, Torres, R, Yecora, A, Motuca, M, Chan, SKW, Zolezzi, M, Ouanes, S, De Berardis, D, Grover, S, Procyshyn, RM, Adebayo, RA, Kirilochev, OO, Soloviev, A, Fountoulakis, KN, Wilkowska, A, Ayub, M, Silva, A, Bonelli, RM, Villagran-Moreno, JM, Crespo-Facorro, B, Temmingh, H, Decloedt, E, Pedro, MR, Takeuchi, H, Tsukahara, M, Gruender, G, Sagud, M, Celofiga, A, Ristic, DI, Ortiz, BB, Elkis, H, Palha, AJP, LLerena, A, Fernandez-Egea, E, Siskind, D, Weizman, A, Masmoudi, R, Saffian, SM, Leung, JG, Buckley, PF, Marder, SR, Citrome, L, Freudenreich, O, Correll, CU, Muller, DJ, Anil Yagcioglu, AE, Radulescu, FS & Cubala, WJ 2022, 'An International Adult Guideline for Making Clozapine Titration Safer by Using Six Ancestry-Based Personalized Dosing Titrations, CRP, and Clozapine Levels', Pharmacopsychiatry, bind 55, nr. 02, s. 73-86. https://doi.org/10.1055/a-1625-6388

APA

de Leon, J., Schoretsanitis, G., Smith, R. L., Molden, E., Solismaa, A., Seppala, N., Kopecek, M., Svancer, P., Olmos, I., Ricciardi, C., Iglesias-Garcia, C., Iglesias-Alonso, A., Spina, E., Ruan, C-J., Wang, C-Y., Wang, G., Tang, Y-L., Lin, S-K., Lane, H-Y., ... Cubala, W. J. (2022). An International Adult Guideline for Making Clozapine Titration Safer by Using Six Ancestry-Based Personalized Dosing Titrations, CRP, and Clozapine Levels. Pharmacopsychiatry, 55(02), 73-86. https://doi.org/10.1055/a-1625-6388

Vancouver

de Leon J, Schoretsanitis G, Smith RL, Molden E, Solismaa A, Seppala N o.a. An International Adult Guideline for Making Clozapine Titration Safer by Using Six Ancestry-Based Personalized Dosing Titrations, CRP, and Clozapine Levels. Pharmacopsychiatry. 2022 mar.;55(02):73-86. https://doi.org/10.1055/a-1625-6388

Author

de Leon, Jose ; Schoretsanitis, Georgios ; Smith, Robert L. ; Molden, Espen ; Solismaa, Anssi ; Seppala, Niko ; Kopecek, Miloslav ; Svancer, Patrik ; Olmos, Ismael ; Ricciardi, Carina ; Iglesias-Garcia, Celso ; Iglesias-Alonso, Ana ; Spina, Edoardo ; Ruan, Can-Jun ; Wang, Chuan-Yue ; Wang, Gang ; Tang, Yi-Lang ; Lin, Shih-Ku ; Lane, Hsien-Yuan ; Kim, Yong Sik ; Kim, Se Hyun ; Rajkumar, Anto P. ; Gonzalez-Esquivel, Dinora F. ; Jung-Cook, Helgi ; Baptista, Trino ; Rohde, Christopher ; Nielsen, Jimmi ; Verdoux, Helene ; Quiles, Clelia ; Sanz, Emilio J. ; De las Cuevas, Carlos ; Cohen, Dan ; Schulte, Peter F. J. ; Ertugrul, Aygun ; Chopra, Nitin ; McCollum, Betsy ; Shelton, Charles ; Cotes, Robert O. ; Kaithi, Arun R. ; Kane, John M. ; Farooq, Saeed ; Ng, Chee H. ; Bilbily, John ; Hiemke, Christoph ; Lopez-Jaramillo, Carlos ; McGrane, Ian ; Lana, Fernando ; Eap, Chin B. ; Arrojo-Romero, Manuel ; Seifritz, Erich ; Every-Palmer, Susanna ; Bousman, Chad A. ; Bebawi, Emmanuel ; Bhattacharya, Rahul ; Kelly, Deanna L. ; Otsuka, Yuji ; Lazary, Judit ; Torres, Rafael ; Yecora, Agustin ; Motuca, Mariano ; Chan, Sherry K. W. ; Zolezzi, Monica ; Ouanes, Sami ; De Berardis, Domenico ; Grover, Sandeep ; Procyshyn, Ric M. ; Adebayo, Richard A. ; Kirilochev, Oleg O. ; Soloviev, Andrey ; Fountoulakis, Konstantinos N. ; Wilkowska, Alina ; Ayub, Muhammad ; Silva, Alzira ; Bonelli, Raphael M. ; Villagran-Moreno, Jose M. ; Crespo-Facorro, Benedicto ; Temmingh, Henk ; Decloedt, Eric ; Pedro, Maria R. ; Takeuchi, Hiroyoshi ; Tsukahara, Masaru ; Gruender, Gerhard ; Sagud, Marina ; Celofiga, Andreja ; Ristic, Dragana Ignjatovic ; Ortiz, Bruno B. ; Elkis, Helio ; Palha, Antonio J. Pacheco ; LLerena, Adrian ; Fernandez-Egea, Emilio ; Siskind, Dan ; Weizman, Abraham ; Masmoudi, Rim ; Saffian, Shamin Mohd ; Leung, Jonathan G. ; Buckley, Peter F. ; Marder, Stephen R. ; Citrome, Leslie ; Freudenreich, Oliver ; Correll, Christoph U. ; Muller, Daniel J. ; Anil Yagcioglu, A. Elif ; Radulescu, Flavian S. ; Cubala, Wieslaw J. / An International Adult Guideline for Making Clozapine Titration Safer by Using Six Ancestry-Based Personalized Dosing Titrations, CRP, and Clozapine Levels. I: Pharmacopsychiatry. 2022 ; Bind 55, Nr. 02. s. 73-86.

Bibtex

@article{a4a674617c8e4226982af94aac41e439,
title = "An International Adult Guideline for Making Clozapine Titration Safer by Using Six Ancestry-Based Personalized Dosing Titrations, CRP, and Clozapine Levels",
abstract = "This international guideline proposes improving clozapine package inserts worldwide by using ancestry-based dosing and titration. Adverse drug reaction (ADR) databases suggest that clozapine is the third most toxic drug in the United States (US), and it produces four times higher worldwide pneumonia mortality than that by agranulocytosis or myocarditis. For trough steady-state clozapine serum concentrations, the therapeutic reference range is narrow, from 350 to 600 ng/mL with the potential for toxicity and ADRs as concentrations increase. Clozapine is mainly metabolized by CYP1A2 (female non-smokers, the lowest dose; male smokers, the highest dose). Poor metabolizer status through phenotypic conversion is associated with co-prescription of inhibitors (including oral contraceptives and valproate), obesity, or inflammation with C-reactive protein (CRP) elevations. The Asian population (Pakistan to Japan) or the Americas' original inhabitants have lower CYP1A2 activity and require lower clozapine doses to reach concentrations of 350 ng/mL. In the US, daily doses of 300-600 mg/day are recommended. Slow personalized titration may prevent early ADRs (including syncope, myocarditis, and pneumonia). This guideline defines six personalized titration schedules for inpatients: 1) ancestry from Asia or the original people from the Americas with lower metabolism (obesity or valproate) needing minimum therapeutic dosages of 75-150 mg/day, 2) ancestry from Asia or the original people from the Americas with average metabolism needing 175-300 mg/day, 3) European/Western Asian ancestry with lower metabolism (obesity or valproate) needing 100-200 mg/day, 4) European/Western Asian ancestry with average metabolism needing 250-400 mg/day, 5) in the US with ancestries other than from Asia or the original people from the Americas with lower clozapine metabolism (obesity or valproate) needing 150-300 mg/day, and 6) in the US with ancestries other than from Asia or the original people from the Americas with average clozapine metabolism needing 300-600 mg/day. Baseline and weekly CRP monitoring for at least four weeks is required to identify any inflammation, including inflammation secondary to clozapine rapid titration.",
keywords = "Native American continental ancestry group, Asian continental ancestry group, clozapine/adverse effects, clozapine/blood, clozapine/metabolism, clozapine/therapeutic use, clozapine/toxicity, drug labeling, European continental ancestry group, infection, inflammation, mortality/drug effects, sex, smoking, TREATMENT-RESISTANT SCHIZOPHRENIA, INDUCED MYOCARDITIS, PLASMA-CONCENTRATIONS, CYP1A2 ACTIVITY, GENETIC POLYMORPHISMS, DOSE TITRATION, SERUM-LEVEL, SMOKING, PHARMACOKINETICS, METABOLITES",
author = "{de Leon}, Jose and Georgios Schoretsanitis and Smith, {Robert L.} and Espen Molden and Anssi Solismaa and Niko Seppala and Miloslav Kopecek and Patrik Svancer and Ismael Olmos and Carina Ricciardi and Celso Iglesias-Garcia and Ana Iglesias-Alonso and Edoardo Spina and Can-Jun Ruan and Chuan-Yue Wang and Gang Wang and Yi-Lang Tang and Shih-Ku Lin and Hsien-Yuan Lane and Kim, {Yong Sik} and Kim, {Se Hyun} and Rajkumar, {Anto P.} and Gonzalez-Esquivel, {Dinora F.} and Helgi Jung-Cook and Trino Baptista and Christopher Rohde and Jimmi Nielsen and Helene Verdoux and Clelia Quiles and Sanz, {Emilio J.} and {De las Cuevas}, Carlos and Dan Cohen and Schulte, {Peter F. J.} and Aygun Ertugrul and Nitin Chopra and Betsy McCollum and Charles Shelton and Cotes, {Robert O.} and Kaithi, {Arun R.} and Kane, {John M.} and Saeed Farooq and Ng, {Chee H.} and John Bilbily and Christoph Hiemke and Carlos Lopez-Jaramillo and Ian McGrane and Fernando Lana and Eap, {Chin B.} and Manuel Arrojo-Romero and Erich Seifritz and Susanna Every-Palmer and Bousman, {Chad A.} and Emmanuel Bebawi and Rahul Bhattacharya and Kelly, {Deanna L.} and Yuji Otsuka and Judit Lazary and Rafael Torres and Agustin Yecora and Mariano Motuca and Chan, {Sherry K. W.} and Monica Zolezzi and Sami Ouanes and {De Berardis}, Domenico and Sandeep Grover and Procyshyn, {Ric M.} and Adebayo, {Richard A.} and Kirilochev, {Oleg O.} and Andrey Soloviev and Fountoulakis, {Konstantinos N.} and Alina Wilkowska and Muhammad Ayub and Alzira Silva and Bonelli, {Raphael M.} and Villagran-Moreno, {Jose M.} and Benedicto Crespo-Facorro and Henk Temmingh and Eric Decloedt and Pedro, {Maria R.} and Hiroyoshi Takeuchi and Masaru Tsukahara and Gerhard Gruender and Marina Sagud and Andreja Celofiga and Ristic, {Dragana Ignjatovic} and Ortiz, {Bruno B.} and Helio Elkis and Palha, {Antonio J. Pacheco} and Adrian LLerena and Emilio Fernandez-Egea and Dan Siskind and Abraham Weizman and Rim Masmoudi and Saffian, {Shamin Mohd} and Leung, {Jonathan G.} and Buckley, {Peter F.} and Marder, {Stephen R.} and Leslie Citrome and Oliver Freudenreich and Correll, {Christoph U.} and Muller, {Daniel J.} and {Anil Yagcioglu}, {A. Elif} and Radulescu, {Flavian S.} and Cubala, {Wieslaw J.}",
year = "2022",
month = mar,
doi = "10.1055/a-1625-6388",
language = "English",
volume = "55",
pages = "73--86",
journal = "Pharmacopsychiatry",
issn = "0176-3679",
publisher = "GeorgThieme Verlag",
number = "02",

}

RIS

TY - JOUR

T1 - An International Adult Guideline for Making Clozapine Titration Safer by Using Six Ancestry-Based Personalized Dosing Titrations, CRP, and Clozapine Levels

AU - de Leon, Jose

AU - Schoretsanitis, Georgios

AU - Smith, Robert L.

AU - Molden, Espen

AU - Solismaa, Anssi

AU - Seppala, Niko

AU - Kopecek, Miloslav

AU - Svancer, Patrik

AU - Olmos, Ismael

AU - Ricciardi, Carina

AU - Iglesias-Garcia, Celso

AU - Iglesias-Alonso, Ana

AU - Spina, Edoardo

AU - Ruan, Can-Jun

AU - Wang, Chuan-Yue

AU - Wang, Gang

AU - Tang, Yi-Lang

AU - Lin, Shih-Ku

AU - Lane, Hsien-Yuan

AU - Kim, Yong Sik

AU - Kim, Se Hyun

AU - Rajkumar, Anto P.

AU - Gonzalez-Esquivel, Dinora F.

AU - Jung-Cook, Helgi

AU - Baptista, Trino

AU - Rohde, Christopher

AU - Nielsen, Jimmi

AU - Verdoux, Helene

AU - Quiles, Clelia

AU - Sanz, Emilio J.

AU - De las Cuevas, Carlos

AU - Cohen, Dan

AU - Schulte, Peter F. J.

AU - Ertugrul, Aygun

AU - Chopra, Nitin

AU - McCollum, Betsy

AU - Shelton, Charles

AU - Cotes, Robert O.

AU - Kaithi, Arun R.

AU - Kane, John M.

AU - Farooq, Saeed

AU - Ng, Chee H.

AU - Bilbily, John

AU - Hiemke, Christoph

AU - Lopez-Jaramillo, Carlos

AU - McGrane, Ian

AU - Lana, Fernando

AU - Eap, Chin B.

AU - Arrojo-Romero, Manuel

AU - Seifritz, Erich

AU - Every-Palmer, Susanna

AU - Bousman, Chad A.

AU - Bebawi, Emmanuel

AU - Bhattacharya, Rahul

AU - Kelly, Deanna L.

AU - Otsuka, Yuji

AU - Lazary, Judit

AU - Torres, Rafael

AU - Yecora, Agustin

AU - Motuca, Mariano

AU - Chan, Sherry K. W.

AU - Zolezzi, Monica

AU - Ouanes, Sami

AU - De Berardis, Domenico

AU - Grover, Sandeep

AU - Procyshyn, Ric M.

AU - Adebayo, Richard A.

AU - Kirilochev, Oleg O.

AU - Soloviev, Andrey

AU - Fountoulakis, Konstantinos N.

AU - Wilkowska, Alina

AU - Ayub, Muhammad

AU - Silva, Alzira

AU - Bonelli, Raphael M.

AU - Villagran-Moreno, Jose M.

AU - Crespo-Facorro, Benedicto

AU - Temmingh, Henk

AU - Decloedt, Eric

AU - Pedro, Maria R.

AU - Takeuchi, Hiroyoshi

AU - Tsukahara, Masaru

AU - Gruender, Gerhard

AU - Sagud, Marina

AU - Celofiga, Andreja

AU - Ristic, Dragana Ignjatovic

AU - Ortiz, Bruno B.

AU - Elkis, Helio

AU - Palha, Antonio J. Pacheco

AU - LLerena, Adrian

AU - Fernandez-Egea, Emilio

AU - Siskind, Dan

AU - Weizman, Abraham

AU - Masmoudi, Rim

AU - Saffian, Shamin Mohd

AU - Leung, Jonathan G.

AU - Buckley, Peter F.

AU - Marder, Stephen R.

AU - Citrome, Leslie

AU - Freudenreich, Oliver

AU - Correll, Christoph U.

AU - Muller, Daniel J.

AU - Anil Yagcioglu, A. Elif

AU - Radulescu, Flavian S.

AU - Cubala, Wieslaw J.

PY - 2022/3

Y1 - 2022/3

N2 - This international guideline proposes improving clozapine package inserts worldwide by using ancestry-based dosing and titration. Adverse drug reaction (ADR) databases suggest that clozapine is the third most toxic drug in the United States (US), and it produces four times higher worldwide pneumonia mortality than that by agranulocytosis or myocarditis. For trough steady-state clozapine serum concentrations, the therapeutic reference range is narrow, from 350 to 600 ng/mL with the potential for toxicity and ADRs as concentrations increase. Clozapine is mainly metabolized by CYP1A2 (female non-smokers, the lowest dose; male smokers, the highest dose). Poor metabolizer status through phenotypic conversion is associated with co-prescription of inhibitors (including oral contraceptives and valproate), obesity, or inflammation with C-reactive protein (CRP) elevations. The Asian population (Pakistan to Japan) or the Americas' original inhabitants have lower CYP1A2 activity and require lower clozapine doses to reach concentrations of 350 ng/mL. In the US, daily doses of 300-600 mg/day are recommended. Slow personalized titration may prevent early ADRs (including syncope, myocarditis, and pneumonia). This guideline defines six personalized titration schedules for inpatients: 1) ancestry from Asia or the original people from the Americas with lower metabolism (obesity or valproate) needing minimum therapeutic dosages of 75-150 mg/day, 2) ancestry from Asia or the original people from the Americas with average metabolism needing 175-300 mg/day, 3) European/Western Asian ancestry with lower metabolism (obesity or valproate) needing 100-200 mg/day, 4) European/Western Asian ancestry with average metabolism needing 250-400 mg/day, 5) in the US with ancestries other than from Asia or the original people from the Americas with lower clozapine metabolism (obesity or valproate) needing 150-300 mg/day, and 6) in the US with ancestries other than from Asia or the original people from the Americas with average clozapine metabolism needing 300-600 mg/day. Baseline and weekly CRP monitoring for at least four weeks is required to identify any inflammation, including inflammation secondary to clozapine rapid titration.

AB - This international guideline proposes improving clozapine package inserts worldwide by using ancestry-based dosing and titration. Adverse drug reaction (ADR) databases suggest that clozapine is the third most toxic drug in the United States (US), and it produces four times higher worldwide pneumonia mortality than that by agranulocytosis or myocarditis. For trough steady-state clozapine serum concentrations, the therapeutic reference range is narrow, from 350 to 600 ng/mL with the potential for toxicity and ADRs as concentrations increase. Clozapine is mainly metabolized by CYP1A2 (female non-smokers, the lowest dose; male smokers, the highest dose). Poor metabolizer status through phenotypic conversion is associated with co-prescription of inhibitors (including oral contraceptives and valproate), obesity, or inflammation with C-reactive protein (CRP) elevations. The Asian population (Pakistan to Japan) or the Americas' original inhabitants have lower CYP1A2 activity and require lower clozapine doses to reach concentrations of 350 ng/mL. In the US, daily doses of 300-600 mg/day are recommended. Slow personalized titration may prevent early ADRs (including syncope, myocarditis, and pneumonia). This guideline defines six personalized titration schedules for inpatients: 1) ancestry from Asia or the original people from the Americas with lower metabolism (obesity or valproate) needing minimum therapeutic dosages of 75-150 mg/day, 2) ancestry from Asia or the original people from the Americas with average metabolism needing 175-300 mg/day, 3) European/Western Asian ancestry with lower metabolism (obesity or valproate) needing 100-200 mg/day, 4) European/Western Asian ancestry with average metabolism needing 250-400 mg/day, 5) in the US with ancestries other than from Asia or the original people from the Americas with lower clozapine metabolism (obesity or valproate) needing 150-300 mg/day, and 6) in the US with ancestries other than from Asia or the original people from the Americas with average clozapine metabolism needing 300-600 mg/day. Baseline and weekly CRP monitoring for at least four weeks is required to identify any inflammation, including inflammation secondary to clozapine rapid titration.

KW - Native American continental ancestry group

KW - Asian continental ancestry group

KW - clozapine/adverse effects

KW - clozapine/blood

KW - clozapine/metabolism

KW - clozapine/therapeutic use

KW - clozapine/toxicity

KW - drug labeling

KW - European continental ancestry group

KW - infection

KW - inflammation

KW - mortality/drug effects

KW - sex

KW - smoking

KW - TREATMENT-RESISTANT SCHIZOPHRENIA

KW - INDUCED MYOCARDITIS

KW - PLASMA-CONCENTRATIONS

KW - CYP1A2 ACTIVITY

KW - GENETIC POLYMORPHISMS

KW - DOSE TITRATION

KW - SERUM-LEVEL

KW - SMOKING

KW - PHARMACOKINETICS

KW - METABOLITES

U2 - 10.1055/a-1625-6388

DO - 10.1055/a-1625-6388

M3 - Review

C2 - 34911124

VL - 55

SP - 73

EP - 86

JO - Pharmacopsychiatry

JF - Pharmacopsychiatry

SN - 0176-3679

IS - 02

ER -

ID: 315543113