Funding for this initiative was made possible (in part) by Grant No. If the patient has no signs of toxicity, possibilities include lab error, a non-trough blood draw, a safe level for this patient, or inhibition of P450 metabolic enzymes from changes in other medications or smoking. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.We use cookies to improve your website experience.

To learn about our use of cookies and how you can manage your cookie settings, please see our Register to receive personalised research and resources by emailThe clozapine to norclozapine ratio: a narrative review of the clinical utility to minimize metabolic risk and enhance clozapine efficacy Schizophrenia Department, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada Schizophrenia Department, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada Schizophrenia Department, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada Schizophrenia Department, Centre for Addiction and Mental Health, Toronto, Canada; Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Canada Schizophrenia Department, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada Centre for Neuropsychiatric Schizophrenia Research, CNSR & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Schizophrenia Department, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada Schizophrenia Department, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada Schizophrenia Department, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada School of Medicine, University of Queensland, Brisbane, Australia; Schizophrenia Department, Metro South Addiction and Mental Health Service, Brisbane, Australia Schizophrenia Department, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Banting and Best Diabetes Centre, University of Toronto, Toronto, Canada/doi/full/10.1080/14740338.2020.1698545?needAccess=true When interpreting blood levels, low clozapine levels can result from low dose, non-adherence, or rapid metabolism. All rights reserved.

When interpreting blood levels, low clozapine levels can result from low dose, non-adherence, or rapid metabolism. E.g.

However, levels should not be the primary determinant of dosage. Levels are usually drawn more than 3 days after a patient is stable on a dose.

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