{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:58:26Z","timestamp":1791986306317,"version":"4.4.0"},"reference-count":58,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T00:00:00Z","timestamp":1774051200000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Dutch Medical Science Foundation ZonMW","award":["10140312310002"],"award-info":[{"award-number":["10140312310002"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Hypothesis<\/jats:title>\n                    <jats:p>Estrogen affects drug metabolism for specific antipsychotics, which may produce sex differences in serum levels, especially over the menopausal transition. Here, we explore sex differences in concentrations of four commonly used antipsychotics: clozapine, olanzapine, aripiprazole, and quetiapine and examined how these vary across age groups, including postmenopause (&amp;gt;55).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Antipsychotic concentrations of 44\u2009378 serum samples drawn between January 2016 and October 2024 were analyzed. Samples were provided by 6147 unique adult men and women for clozapine (n\u00a0=\u200934\u2009761 samples, 26% female), olanzapine (n\u00a0=\u20095114, 27% female), aripiprazole (n\u00a0=\u20093171, 37% female), and quetiapine (n\u00a0=\u20091332, 50% female). To investigate the effect of sex and age on antipsychotic concentrations, we employed linear mixed-effects models and pairwise contrasts by dividing the samples in 6 groups according to sex and age (&amp;lt;45, 45-55, and &amp;gt;55\u00a0years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Results<\/jats:title>\n                    <jats:p>We found higher concentrations in women compared to men for clozapine (P\u00a0&amp;lt;\u2009.001), and olanzapine (P\u00a0&amp;lt;\u2009.001), but not for quetiapine or aripiprazole. Young women (&amp;lt;45) showed higher levels of clozapine (P\u00a0=\u2009.004) and olanzapine (P\u00a0&amp;lt;\u2009.001) than men, but older women did not. Clozapine levels were higher in women &amp;lt;45 and 45-55 compared to women &amp;gt;55\u00a0years (all P\u00a0&amp;lt;\u2009.05). For olanzapine, aripiprazole, and quetiapine concentrations differences between female age groups were absent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found sex differences in olanzapine and clozapine concentrations, which were most pronounced until 45\u00a0years of age. Our findings suggest that monitoring antipsychotic levels may add clinical value and underscore the need for sex-specific prescription guidelines for olanzapine and clozapine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/schbul\/sbaf217","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T13:25:10Z","timestamp":1763731510000},"source":"Crossref","is-referenced-by-count":4,"title":["The Impact of Sex and Age on Antipsychotic Serum Concentrations"],"prefix":"10.1093","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0740-0969","authenticated-orcid":false,"given":"Franciska","family":"de Beer","sequence":"first","affiliation":[{"name":"Center for Clinical Neuroscience and Cognition, University Medical Center Groningen, University of Groningen , Groningen , 9713 AP,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bodyl A","family":"Brand","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Oxford , Oxford , OX3 7JX,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Wijnen","sequence":"additional","affiliation":[{"name":"Centre of Economic Evaluations & Machine Learning, Trimbos Institute, Netherlands Institute of Mental Health and Addiction , Utrecht , 3521 VS,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0084-8226","authenticated-orcid":false,"given":"Shiral S","family":"Gangadin","sequence":"additional","affiliation":[{"name":"Center for Clinical Neuroscience and Cognition, University Medical Center Groningen, University of Groningen , Groningen , 9713 AP,","place":["The Netherlands"]},{"name":"Rob Giel Research Center, University Center Psychiatry, University Medical Center Groningen, University of Groningen , Groningen , 9713 GZ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Schoretsanitis","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich , Zurich , 8008,","place":["Switzerland"]},{"name":"Department of Psychiatry, Northwell Health, The Zucker Hillside Hospital , Glen Oaks, NY , 11004,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daan","family":"Touw","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen , Groningen , 9713 GZ,","place":["The Netherlands"]},{"name":"Department of Pharmaceutical Analysis, Groningen Research Institute of Pharmacy, University of Groningen , Groningen , 9713 AV,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris E 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