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Clozapine Levels Are Clinical Clues—Not Treatment Targets
What is the “right” plasma clozapine concentration? A new dose-response meta-analysis in Psychiatry Research offers several provocative numbers. But its most important contribution may be its warning against treating those numbers as universal thresholds. Fornaro and colleagues examined the relationships between plasma clozapine and norclozapine concentrations, therapeutic response and adverse outcomes in people with schizophrenia-spectrum disorders. Their findings reinforce
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Antipsychotic Response Does Not Run on One Clock
When should an antipsychotic be judged effective—or ineffective? The usual answer is expressed in weeks. But a new study in The Lancet Psychiatry suggests that the more clinically useful question may be: Which symptoms are we waiting to improve? Leucht and colleagues analyzed individual-participant data from six antipsychotic trials involving 2,079 people with acute schizophrenia. Their findings show that the major symptom domains of schizophrenia improve on meaningfully diff
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Tuberculosis in California: 2025 Snapshot
1. Core Framework: "Getting to Zero" (Barry et al., 2016) The primary thesis established by Barry et al. in Current Epidemiology Reports (2016) is that standard TB control measures (prompt case finding and treatment of active disease) are insufficient for elimination. The Latent TB Infection (LTBI) Reservoir: The vast majority of active TB cases in California (>80%) stem from the reactivation of longstanding, untreated latent TB infections rather than recent transmission with
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Targeted protein degraders: Blood–brain barrier permeability and central nervous system exposure
Targeted protein degraders (TPDs), including PROTACs, are emerging as a revolutionary therapeutic strategy for central nervous system (CNS) proteinopathies by leveraging the body's cellular machinery to completely destroy disease-causing misfolded proteins. However, delivering these chemical macromolecules across the blood-brain barrier (BBB) presents a monumental challenge. Standard CNS drugs typically adhere to strict physicochemical parameters, such as low molecular weight
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