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IN THIS ISSUE:
January 2013

Adjunctive Metformin in Chronic Psychosis?
Adding metformin (Glucophage and others) to an antipsychotic regimen may help prevent weight gain and associated adverse effects in patients with schizophrenia.

DBS or TMS for AD?
Preliminary results suggest possible benefit for patients with Alzheimer disease from deep brain stimulation and transcranial magnetic stimulation.

Bone Health with Antidepressants and Antipsychotics
Some antidepressants increase the risk of nonvertebral fractures in postmenopausal women, whereas clozapine (Clozaril and others) may help protect bone mineral density.

In Brief
Earliest Biomarker Changes in People Genetically Predisposed to Alzheimer Disease Begin Decades before Illness Onset; Internet-Delivered Management Care Improves Outcomes for People with Depression

Clozapine-Caffeine Interaction
Caffeine consumption can inhibit cytochrome P450 1A2, which can elevate clozapine (Clozaril and others) and norclozapine serum levels.

5-Year Bound Volume
The 2008-2012 BTP bound volume is now available in both print and electronic formats.

Antipsychotic Exposure and Parkinson Disease
Exposure to antipsychotics in elderly patients may increase the risk of Parkinson disease, as well as drug-induced parkinsonism.

Clozapine-Caffeine Interaction

January 2013

The cytochrome P450 (CYP) 1A2 enzyme is primarily responsible for the biotransformation of clozapine (Clozaril and others) to norclozapine, a first step in clozapine's metabolism. Caffeine inhibits CYP1A2. Al Hadithy and others report on a patient whose clozapine levels appeared substantially elevated…

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