An improved HPLC-ED method for monitoring plasma levels of clozapine and its active metabolites in schizophrenic patients

Summary An HPLC method with electrochemical detection has been developed for the determination of clozapine and its main metabolites, desmethylclozapine and clozapine N-oxide, in human plasma. An accurate pretreatment of the biological samples was implemented by means of solid phase extraction (SPE) on HLB cartridges. This improved pretreatment, together with a new mobile phase, allows for the accurate determination of clozapine N-oxide, which could not be quantitated by a previous method. The method uses only 100 μL of plasma for one complete analysis and shows good recovery values for all three analytes. The eluates from the SPE procedure were chromatographed in a reversed phase C18 column using a mobile phase composed of phosphate buffer, acetonitrile and methanol. Clozapine, desmethylclozapine and clozapine N-oxide were eluted in less than 10 minutes, without any interference from the biological matrix. Linearity was observed over the 2.50–150 ng mL⁻¹ (clozapine and desmethylclozapine) or 1.25–75 ng mL⁻¹ clozapine N-oxide) range for the three analytes, with satisfactory repeatability values. The limit of detection was 0.3 ng mL⁻¹ for clozapine and desmethylclozapine, samples of patients treated with Leponex gave good results. No interference from other common central nervous system drugs was found. This method seems to be a useful tool for pharmacokinetic studies and for clinical monitoring, because of its need for small plasma samples and its high sensitivity and selectivity.