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Artigos de revistas sobre o tema "Clozapine"

Autor: Grafiati

Publicado: 4 de junho de 2021

Última modificação: 25 de julho de 2025

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1

Pardis, Parnian, Gary Remington, Roshni Panda, Milan Lemez, and Ofer Agid. "Clozapine and tardive dyskinesia in patients with schizophrenia: A systematic review." Journal of Psychopharmacology 33, no. 10 (2019): 1187–98. http://dx.doi.org/10.1177/0269881119862535.

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Background: It is commonly recommended that a switch to clozapine be implemented in the face of tardive dyskinesia, even if current treatment involves another “atypical” agent. However, reports do indicate clozapine carries a liability for tardive dyskinesia. Aims: This review sought to evaluate clozapine in relation to tardive dyskinesia in the context of available evidence. Methods: Medline, Embase, and PsycINFO databases were searched for studies published in English, using the keywords: clozapine AND tardive dyskinesia OR TD. References from major review articles were searched for addition

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Qubad, Mishal, and Robert A. Bittner. "Second to none: rationale, timing, and clinical management of clozapine use in schizophrenia." Therapeutic Advances in Psychopharmacology 13 (January 2023): 204512532311581. http://dx.doi.org/10.1177/20451253231158152.

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Despite its enduring relevance as the single most effective and important evidence-based treatment for schizophrenia, underutilization of clozapine remains considerable. To a substantial degree, this is attributable to a reluctance of psychiatrists to offer clozapine due to its relatively large side-effect burden and the complexity of its use. This underscores the necessity for continued education regarding both the vital nature and the intricacies of clozapine treatment. This narrative review summarizes all clinically relevant areas of evidence, which support clozapine’s wide-ranging superior

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Rajkumar, Anto P., B. Poonkuzhali, Anju Kuruvilla, Alok Srivastava, Molly Jacob, and K. S. Jacob. "Association betweenCYP1A2gene single nucleotide polymorphisms and clinical responses to clozapine in patients with treatment-resistant schizophrenia." Acta Neuropsychiatrica 25, no. 1 (2013): 2–11. http://dx.doi.org/10.1111/j.1601-5215.2012.00638.x.

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ObjectivesDespite clozapine's superior clinical efficacy in treatment-resistant schizophrenia (TRS), its adverse effects, need for periodic leukocyte monitoring, cost and variable clinical outcomes mandate a clinical need to predict its treatment response. Although cytochrome P450 1A2 (CYP1A2) is the principal determinant of metabolism of clozapine, the role ofCYP1A2gene in the clinical response to clozapine is uncertain. Hence, we investigated its association with treatment responses and adverse events of clozapine in TRS.MethodsWe evaluated four single nucleotide polymorphisms (SNP) in theCY

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Lieberman, Jeffrey A., Bruce L. Saltz, Celeste A. Johns, Simcha Pollack, Michael Borenstein, and John Kane. "The Effects of Clozapine on Tardive Dyskinesia." British Journal of Psychiatry 158, no. 4 (1991): 503–10. http://dx.doi.org/10.1192/bjp.158.4.503.

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This article reviews eight published studies that describe clozapine's effects on TD and examines the outcome of 30 patients with TD treated with clozapine for up to 36 months. These data indicate that TD response to clozapine is variable but that approximately 43% of cases, particularly those with dystonic features, improved after clozapine treatment. Methodological limitations of the studies described, however, preclude definitive conclusions, which must await appropriately controlled trials.

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Coward, D. M. "General Pharmacology of Clozapine." British Journal of Psychiatry 160, S17 (1992): 5–11. http://dx.doi.org/10.1192/s0007125000296840.

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Clozapine shows neuroleptic-like inhibition of locomotor activity and conditioned avoidance responding in rodents, although tolerance develops on repeated treatment. EEG-based studies show strong arousal-inhibiting activity of clozapine as well as neuroleptic-like effects on both caudate spindle duration and rat sleep-waking patterns. Effects such as apomorphine blockade, catalepsy and strong increases of plasma prolactin levels are not seen, however, and chronic treatment does not lead to dopamine D2 receptor supersensitivity. Binding studies show clozapine's highest affinities to be for dopa

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Oliveira-Souza, Ricardo de, Rogério Paysano Marrocos, and Jorge Moll. "Clozapine for severe ("kraepelinian") schizophrenia: Sustained improvement over 5 years." Dementia & Neuropsychologia 2, no. 1 (2008): 71–75. http://dx.doi.org/10.1590/s1980-57642009dn20100014.

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Abstract Clozapine has become a keystone in the treatment of schizophrenia because of its efficacy as an antipsychotic with negligible neuroleptic effects. The long-term stability of its effects, however, is poorly understood, because most studies have probed the usefulness of clozapine over a period of weeks to several months at the most. Knowing whether clozapine's benefits are sustained over the very long-term, i.e., more than 5 years, may be critical for cost-benefit analyses. Objective: To report the results of an open study on the efficacy of clozapine over the very long-term. Methods: T

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Dell’Osso, Liliana, Chiara Bonelli, Benedetta Nardi, et al. "Rethinking Clozapine: Lights and Shadows of a Revolutionary Drug." Brain Sciences 14, no. 1 (2024): 103. http://dx.doi.org/10.3390/brainsci14010103.

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The current literature globally highlights the efficacy of Clozapine in several psychiatric disorders all over the world, with an FDA indication for reducing the risk of repeated suicidal behavior in patients with schizophrenia or schizoaffective disorder. A growing field of research is also stressing a possible broader beneficial effect of Clozapine in promoting neuroprotection and neurotrophism. However, this drug is linked to several life-threatening side effects, such as agranulocytosis, myocarditis and seizures, that limit its use in daily clinical practice. For this work, a search was pe

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Orejas, O., C. Masferrer Herrera, C. Macías Castellví, and P. Flores Martínez. "Subacute psychiatric hospitalization unit: The role of clozapine." European Psychiatry 33, S1 (2016): S548—S549. http://dx.doi.org/10.1016/j.eurpsy.2016.01.2026.

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IntroductionSeveral studies report that Clozapine is more effective in reducing symptoms of schizophrenia, producing clinically meaningful improvements and postponing relapse than other antipsychotic strategies.ObjectivesTo analyze the prescription of Clozapine in a sample of 88 inpatients admitted to a subacute psychiatric hospitalization unit.MethodsThis is a transversal study. All patients admitted for a medium-term psychiatric treatment since 01/06/2014 to 30/11/2015 were included. Data about socio-demographical status and clinical situation were obtained and compiled in a database. This s

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Stanton, Robert J., Chris Paxos, Werner J. Geldenhuys, et al. "Clozapine underutilization in treatment-resistant schizophrenia." Mental Health Clinician 5, no. 2 (2015): 63–67. http://dx.doi.org/10.9740/mhc.2015.03.063.

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Abstract It has been shown that up to one third of patients with schizophrenia do not respond to antipsychotic therapy. Thus, treatment-resistant schizophrenia (TRS) remains a major mental health care challenge. Clozapine has been shown to provide superior therapeutic benefits and is approved as first-line therapy for TRS. These benefits include improvement in both positive and negative symptoms, and reduction of suicidal behavior in patients with schizophrenia. Clozapine, however, remains significantly underused for TRS. A major reason for clozapine's underuse is its substantial adverse effec

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Fehsel, K., K. Schwanke, BA Kappel, et al. "Activation of the aryl hydrocarbon receptor by clozapine induces preadipocyte differentiation and contributes to endothelial dysfunction." Journal of Psychopharmacology 36, no. 2 (2022): 191–201. http://dx.doi.org/10.1177/02698811211055811.

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Background: The superior therapeutic benefit of clozapine is often associated with metabolic disruptions as obesity, insulin resistance, tachycardia, higher blood pressure, and even hypertension. Aims: These adverse vascular/ metabolic events under clozapine are similar to those caused by polycyclic aromatic hydrocarbons (PAHs), and clozapine shows structural similarity to well-known ligands of the aryl hydrocarbon receptor (AhR). Therefore, we speculated that the side effects caused by clozapine might rely on AhR signaling. Methods: We examined clozapine-induced AhR activation by luciferase r

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Davis, Erica A. K., and Deanna L. Kelly. "Clozapine-associated renal failure: A case report and literature review." Mental Health Clinician 9, no. 3 (2019): 124–27. http://dx.doi.org/10.9740/mhc.2019.05.124.

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Abstract One of clozapine's unrecognized potential side effects is renal insufficiency and nephritis. Although most clinicians are aware of the possibility of clozapine-induced myocarditis, less is known about other inflammatory disorders due to clozapine treatment. This patient was started on lithium and clozapine within 4 days of each other although lithium was discontinued after 7 days due to tremor. Routine labs showed an increase in serum creatinine, which was initially attributed to the recent lithium. However, the patient's kidney function continued to worsen, requiring discontinuation

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Jalenques, Isabelle, and André-Julien Coudert. "Clozapine for the treatment of levodopa-induced psychosis and dyskinesia in Parkinson's disease." Irish Journal of Psychological Medicine 11, no. 2 (1994): 83–88. http://dx.doi.org/10.1017/s0790966700012404.

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AbstractThe treatment of psychosis in patients with Parkinson's disease (PD) is one of the most difficult problems in clinical psychiatry. Clozapine's low propensity to induce extrapyramidal side effects makes it an attractive treatment for psychotic patients with PD. A number of published uncontrolled studies suggest that low-dose clozapine is effective in these patients. However, the dose range, side effect profiles and length of treatment have varied in these reports. In this article, the authors review the literature and report on the effects of clozapine in a patient with Parkinson's dise

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Kenton, Emma M., Samantha M. Zoellner, and Leigh Anne Nelson. "Diltiazem for clozapine-induced generalized hyperhidrosis." Mental Health Clinician 13, no. 4 (2023): 193–95. http://dx.doi.org/10.9740/mhc.2023.08.193.

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Abstract Background Clozapine can be associated with significant side effects and tolerability issues. Hyperhidrosis occurs less commonly and is unanticipated by clinicians because of clozapine's significant anticholinergic activity. Case Report A 34-year-old female developed clozapine-induced nocturnal, generalized hyperhidrosis following initial titration to 400 mg/day. Dose reduction did not decrease the side effect. Treatment with an anticholinergic medication could not be initiated because of constipation. Treatment with a beta blocker resulted in worsening of asthma. Treatment with a cal

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Marcelino, Carla R. B., and Clarissa de R. Dantas. "Clozapine-induced severe eosinophilia: report of a case with good outcome." Jornal Brasileiro de Psiquiatria 62, no. 3 (2013): 240–43. http://dx.doi.org/10.1590/s0047-20852013000300009.

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INTRODUCTION: Clozapine is the antipsychotic of choice in the treatment of refractory schizophrenia. However, its side effects, such as eosinophilia, may preclude its use. METHODS: Case report and literature review. RESULTS: Young woman, 19 years old, diagnosed with hebefrenic schizophrenia, admitted at Unicamp's psychiatry ward after psychotic symptoms relapse. Clozapine was started after unsuccessful attempts with risperidon and olanzapine. By the fourth week of clozapine use, eosinophils began to increase. Drug titration was stopped, but eosinophils counts continued to rise up, reaching the

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Sulejmanpasic, G., and S. Bise. "Clozapine augmented with risperidone in treatment-resistant schizophrenia." European Psychiatry 41, S1 (2017): S385. http://dx.doi.org/10.1016/j.eurpsy.2017.02.424.

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IntroductionThe evolution of various pharmacological therapies for schizophrenia has given rise to several pharmacological models for the neuroreceptor targets of antipsychotics and the influence of various neuroreceptors on specific symptoms and side effects.ObjectivesExperience in clinical practice affirms clozapine's position as the treatment of choice for patients with treatment-refractory schizophrenia. Unlike clozapine, risperidone has a more targeted profile of neurotransmitter binding, with particular predilection for dopamine and serotonin receptors. Risperidone is, to date, the most

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Kirwan, P., L. O’Connor, K. Sharma, and C. McDonald. "The impact of switching to clozapine on psychiatric hospital admissions: a mirror-image study." Irish Journal of Psychological Medicine 36, no. 4 (2017): 259–63. http://dx.doi.org/10.1017/ipm.2017.28.

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BackgroundClozapine is an atypical antipsychotic agent used primarily in the management of treatment-resistant schizophrenia. Previous studies have demonstrated clozapine’s superior efficacy over other antipsychotic medications in treating this population of patients. The aim of this study was to assess if the number of hospital admissions and days spent in hospital reduced with the initiation of clozapine, compared with when the same sample of patients were prescribed other antipsychotics prior to clozapine initiation.MethodA mirror-image study design was adopted. In this case the interventio

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Kumar Agrawal, Adesh, Soumitra Das, Lorenzo Abednego B. Adre, Nakka Raghuma, Sharanya Kaushik, and Adarsha Adhikari. "A Case Report of a Patient with Soaring Clozapine Levels after Developing a Urinary Tract Infection." Case Reports in Psychiatry 2024 (February 20, 2024): 1–4. http://dx.doi.org/10.1155/2024/9147674.

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Clozapine is an antipsychotic medicine used to treat mental illnesses that is resistant to therapy. It can induce dose-dependent adverse effects such as increased susceptibility to infections and hematological irregularities. In this case report, we present a 37-year-old woman with schizoaffective disorder who experienced clozapine side effects following a moderate urinary tract infection (UTI). Her serum clozapine levels and side effects were increased throughout her UTI but resolved once the UTI was managed conservatively. We reviewed clozapine’s pharmacokinetic properties to understand why

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Kubota, Takashi, Itsuki Jibiki, Akira Ishikawa, Tomomi Kawamura, Sonoko Kurokawa, and Man Wang. "Increase in extracellular dopamine levels during clozapine-induced potentiation in the hippocampal dentate gyrus of chronically prepared rabbits." Canadian Journal of Physiology and Pharmacology 86, no. 5 (2008): 249–56. http://dx.doi.org/10.1139/y08-036.

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We previously found that 20 mg/kg clozapine i.p. potentiated the excitatory synaptic responses elicited in the dentate gyrus by single electrical stimulation of the perforant path in chronically prepared rabbits. We called this phenomenon clozapine-induced potentiation and proved that it was an NMDA receptor-mediated event. This potentiation is presumably related to clozapine’s clinical effect on negative symptoms and cognitive dysfunctions in schizophrenia. In the present study, to investigate the mechanisms underlying clozapine-induced potentiation, we examined whether extracellular dopamine

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Freudenreich, O. "Augmentation strategies for treatment-refractory clozapine patients." European Psychiatry 64, S1 (2021): S31. http://dx.doi.org/10.1192/j.eurpsy.2021.109.

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BackgroundClozapine can be a life-saving and course-altering treatment for patients with psychosis, particularly treatment-resistant schizophrenia. Unfortunately, clozapine monotherapy rarely leads to a full symptomatic remission.AimsThis talk outlines key decision points in the use of clozapine: how to select patients for clozapine treatment and how to optimize clozapine’s efficacy in patients with a poor response to an adequate clozapine monotherapy trial.ConclusionsClozapine’s main indication is for treatment-resistant schizophrenia. Therapeutic drug monitoring (TDM) should be used to optim

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Nasyrova, R. F., A. V. Kidyaeva, V. V. Grechkina, M. M. Petrova, and N. A. Shnayder. "Personalized Approach to Prediction and Prevention Clozapine-Induced QT Prolongation." Psychiatry (Moscow) (Psikhiatriya) 22, no. 5 (2025): 75–86. https://doi.org/10.30629/2618-6667-2024-22-5-75-86.

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Background: antipsychotics are widely used in psychiatry. Clozapine remains an indispensable antipsychotic due to its effectiveness. However, it has a wide range of undesirable effect, including an increased risk of QT prolongation, a potentially fatal complication that can lead to Torsade de Pointes (TdP) and sudden cardiac death. Objective: to systematize information for practicing psychiatrists about a personalized approach to the prevention of QT interval prolongation in patients with mental disorders when taking clozapine. Methods: a search for full-text articles published from 02/01/2014

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Bunney, Benjamin S. "Clozapine: A Hypothesised Mechanism for its Unique Clinical Profile." British Journal of Psychiatry 160, S17 (1992): 17–21. http://dx.doi.org/10.1192/s0007125000296864.

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Clozapine's clinical profile is unique among antipsychotic drugs. What makes it different? For almost two decades researchers have been attempting to answer this question. Based on various data, many hypotheses have been proposed. Using electrophysiological techniques we have found that clozapine, like typical antipsychotic drugs, inactivates most midbrain dopamine cells secondary to the induction of depolarisation block. However, unlike classical antipsychotic drugs, clozapine does not inactivate the nigrostriatal dopamine system. Based on these and other findings the hypothesis of ‘depolaris

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Fernando, Tharushi, and Ritesh Bhandarkar. "Consumer Survey on the Experience of Clozapine Treatment and Monitoring Process in an Australian Community Mental Health Service." BJPsych Open 10, S1 (2024): S135—S136. http://dx.doi.org/10.1192/bjo.2024.363.

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AimsClozapine is a well-established and widely practiced treatment for treatment-resistant schizophrenia. Due to its significant side effect profile, it requires intense monitoring, including monthly blood tests and medical reviews. A patient's attitude towards clozapine can impact compliance with treatment and its monitoring process. This survey intended to identify the community mental health patients' perception of the clozapine treatment and its monitoring process and to help improve current practices of the service.MethodsA structured survey with 17 questions was administered to patients

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Cairns, Rebecca, and Stephen Guy. "Clozapine initiation in the Belfast Health and Social Care Trust (BHSCT)." BJPsych Open 7, S1 (2021): S177. http://dx.doi.org/10.1192/bjo.2021.482.

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AimsThe aim of this project is to improve the quality of documentation and recording of the assessment and monitoring of patients commencing clozapine in BHSCT.BackgroundClozapine is an effective treatment for patients with schizophrenia who have not responded to at least two other antipsychotics. Due to clozapine's significant side effect profile patients must be carefully assessed prior to treatment initiation with close monitoring of their physical observations and reported side effects during initiation.The BHSCT Clozapine Pathway currently uses a Clozapine Assessment Integrated Care Pathw

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Chang, Geng-Ruei, Hsien-Yueh Liu, Wei-Cheng Yang, et al. "Clozapine Worsens Glucose Intolerance, Nonalcoholic Fatty Liver Disease, Kidney Damage, and Retinal Injury and Increases Renal Reactive Oxygen Species Production and Chromium Loss in Obese Mice." International Journal of Molecular Sciences 22, no. 13 (2021): 6680. http://dx.doi.org/10.3390/ijms22136680.

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Clozapine is widely employed in the treatment of schizophrenia. Compared with that of atypical first-generation antipsychotics, atypical second-generation antipsychotics such as clozapine have less severe side effects and may positively affect obesity and blood glucose level. However, no systematic study of clozapine’s adverse metabolic effects—such as changes in kidney and liver function, body weight, glucose and triglyceride levels, and retinopathy—was conducted. This research investigated how clozapine affects weight, the bodily distribution of chromium, liver damage, fatty liver scores, gl

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Gire, Nadeem, Atta Asif, and Nusrat Husain. "Longitudinal Trend Evaluation and Prescription Cost Analysis (PCA) of Clozapine in the United Kingdom." BJPsych Open 10, S1 (2024): S37. http://dx.doi.org/10.1192/bjo.2024.150.

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AimsSevere Mental Illnesses (SMI) are a group of disorders which can have a debilitating impact on an individual's daily life functioning. The National Institute for Health and Care Excellence (NICE) has set out clinical guidelines for the treatment of SMI including the use of Second Generation Antipsychotic (SGA) medication as well as psychological therapies. However, Treatment Resistant Schizophrenia (TRS) affects approximately 34% of patients with schizophrenia. Clozapine, a SGA, has shown superiority in treatment resistant schizophrenia as well as its potential benefits in reducing suicida

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Hirsch, Steven R., Christopher G. G. Link, Jeffrey M. Goldstein, and Lisa A. Arvanitis. "ICI 204, 636: A New Atypical Antipsychotic Drug." British Journal of Psychiatry 168, S29 (1996): 45–56. http://dx.doi.org/10.1192/s0007125000298310.

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The therapeutic effects of ‘classic’ (typical) antipsychotic agents lie in their ability to block central dopaminergic receptors – a property that is also responsible for the frequent occurrence of undesirable extrapyramidal side-effects (EPS). In contrast to these typical agents, clozapine alone has distinguished itself in humans – by virtue of its enhanced antipsychotic action and lack of concurrent EPS – as an atypical antipsychotic. However, the use of clozapine has been limited by the occurrence of agranulocytosis and, to a lesser extent, seizures (Alvir et al, 1993; Haring et al, 1994).

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Haile, Kibrom, and Halima Umer. "The use of clozapine and clonazepam co-administration in the treatment of a severe tardive dyskinesia: A case report." SAGE Open Medical Case Reports 7 (January 2019): 2050313X1983325. http://dx.doi.org/10.1177/2050313x19833254.

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This is a case report of a patient who was treated with clozapine and clonazepam after he developed neuroleptic-induced tardive dyskinesia following treatment for schizophrenia. There are reports of clozapine treatment itself causing tardive dyskinesia; however, more reports have shown clozapine’s benefit for patients with neuroleptic-induced tardive dyskinesia. This is a case report of a patient with neuroleptic-induced tardive dyskinesia who benefitted from clozapine treatment with adjuvant use of clonazepam – the first such case report from Ethiopia. A 43-year-old male patient developed sev

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Murphy, Kate, Ian Coombes, Sara McMillan, and Amanda J. Wheeler. "Clozapine and shared care: the consumer experience." Australian Journal of Primary Health 24, no. 6 (2018): 455. http://dx.doi.org/10.1071/py18055.

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Clozapine is a high-risk medication with restrictions that may increase consumer treatment burden. Shared care may improve access, reduce burden and promote primary care management. However, knowledge about the consumer experience of clozapine treatment within a shared-care setting has not been previously reported to the authors’ knowledge. The aim of this study was to explore the consumer experience within the shared-care setting. This mixed-methods study examined consumers’ experiences with a clozapine shared-care program in an urban setting in Queensland, Australia. Eligible consumers (n=35

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Peinado, A. Gomez, P. Cano Ruiz, S. Cañas Fraile, M. Gonzalez Cano, and G. E. Barba Fajardo. "Clozapine induced blood dyscrasias and a therapeutical approach." European Psychiatry 33, S1 (2016): S613. http://dx.doi.org/10.1016/j.eurpsy.2016.01.2293.

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IntroductionClozapine is a neuroleptic commonly used in treatments resistant to schizophrenia. However, despite the benefits, clozapine might cause some serious side effects. Hence, it is of the utmost necessity to keep an exacting control of the patients.ObjectivesTo study some of the therapeutical approaches to the treatment of clozapine induced neutropenia and agranulocytosis.MethodsReview of some articles in Mental Health Journals.ResultsThe treatment with clozapine, substratum of aminergic and muscarinic receptors, entails a 0.9% risk of causing agranulocytosis, and approximately a 2.7% r

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Fernando, Tharushi, Ritesh Bhandarkar, and Graham Meadows. "Clinical Audit of Clozapine Prescribing Practice and Monitoring Process in an Australian Community Mental Health Service." BJPsych Open 8, S1 (2022): S4—S5. http://dx.doi.org/10.1192/bjo.2022.83.

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AimsClozapine, a well-established treatment of choice for treatment-resistant schizophrenia is known to reduce suicidality, lessen the risk of tardive dyskinesia and reduce relapse risk. It contributes to a higher quality of life by reducing cognitive clouding. Patients taking Clozapine have improved social and work functioning. But Clozapine's significant side effects require regular, intense monitoring to minimize mortality and morbidity. To improve current practice of clozapine prescribing and monitoring, a systematic audit of service practices against guidelines of local hospital / Monash

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Dickson, Ruth A., Richard Williams, and J. Thomas Dalby. "The Clozapine Experience from a Family Perspective." Canadian Journal of Psychiatry 40, no. 10 (1995): 627–29. http://dx.doi.org/10.1177/070674379504001010.

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Objective To examine how the lives of family members of clozapine-treated patients with schizophrenia have been affected by this treatment. Methods Through the use of a questionnaire and an interview of family members, this qualitative study focused on the families' perceptions of change in their family member and the impact on the family unit. Results Fourteen patients and their family members participated. The family interview was conducted an average of 1.78 years after clozapine inititation (range 0.58 years to 3.73 years). Global ratings of behavioural change were positively and significa

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Muñoz-Manchado, L. I., F. González-Saiz, J. I. Pérez-Revuelta, N. Laherrán-Cantera, and R. J. Pardo-Velasco. "Analysis of the predictive potential of good clinical response of plasma levels of clozapine in patients with resistant schizophrenia in an area of southern Spain." European Psychiatry 66, S1 (2023): S446. http://dx.doi.org/10.1192/j.eurpsy.2023.959.

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IntroductionResistant schizophrenia is a schizophrenia subtype characterized by a non-ability to respond to an appropriate antipsychotic treatment in dosage and duration by the patients. These patients show a lower prognostic and symptomatology. The unique drug which has shown efficacy for resistant schizophrenia treatment is clozapine, which is effective in suicide and aggressive behaviour prevention too. Whereas clozapine has numerous and serious adverse effects such as agranulocytosis risk. Because of this, and for guaranteeing an accurate diagnosis of resistant schizophrenia, distinguishin

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&NA;. "Clozapine see Imipramine/clozapine." Reactions Weekly &NA;, no. 309 (1990): 4. http://dx.doi.org/10.2165/00128415-199003090-00013.

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Remington, Gary J., Donald Addington, Evan J. Collins, et al. "Clozapine: Current Status and Role in the Pharmacotherapy of Schizophrenia." Canadian Journal of Psychiatry 41, no. 3 (1996): 161–66. http://dx.doi.org/10.1177/070674379604100306.

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Objective: This study evaluates clozapine and its present role in the pharmacotherapy of schizophrenia. Method: Clozapine's current clinical status is reviewed, as is its position with respect to other treatment options. Results: Clozapine represents the prototype of “atypical” neuroleptics, with evidence of clinical efficacy in both positive and negative symptoms, as well as a diminished risk of extrapyramidal side effects. It is the only neuroleptic to date that has established itself as having little, if any, risk of tardive dyskinesia. More recent research has focused on its potential for

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Farakish, Lily, Laura Raducu, and Anthony Soares. "Clozapine Rechallenge in Treatment-Resistant Schizophrenia: Clinical and Ethical Considerations After Ileus." BJPsych Open 11, S1 (2025): S300—S301. https://doi.org/10.1192/bjo.2025.10725.

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Aims: Clozapine is the cornerstone of treatment for treatment-resistant schizophrenia. It primarily acts by inhibiting dopamine D2 receptors based on the hyperdopaminergic theory of psychosis. Additionally, second-generation antipsychotics (SGAs) interact with serotonin receptors (5-HT2A and 5-HT1A), mitigating extrapyramidal side effects. However, widespread activity on D2 receptors and additional anticholinergic effects can impact gastrointestinal motility, leading to complications such as paralytic ileus. Clozapine has potent anticholinergic activity and is associated with higher risks of p

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Edinoff, Amber N., Emily Sauce, Carolina O. Ochoa, et al. "Clozapine and Constipation: A Review of Clinical Considerations and Treatment Options." Psychiatry International 2, no. 3 (2021): 344–52. http://dx.doi.org/10.3390/psychiatryint2030026.

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Psychosis, a break in reality which is manifested as hallucinations, delusions or the disruption in thought process, is the hallmark of schizophrenia. Despite novel pharmacotherapy advancements of antipsychotic medications that have resulted in some patients having the ability to return to social settings and thereby decreasing psychotic symptoms and reducing hospital admissions, there is still a sub-population of patients who remain symptomatic. Treatment-resistant schizophrenia is defined as failure of treatment with at least two different antipsychotics with the proper length of treatment a

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Shih, Yu-Ju, Ching-Hua Lin, and Li-Shiu Chou. "The factors associated with clozapine polypharmacy for schizophrenia patients discharged from a large public psychiatric hospital in Taiwan, 2006–2021." Medicine 103, no. 51 (2024): e40897. https://doi.org/10.1097/md.0000000000040897.

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Clozapine treatment continues to be recognized as the gold standard for managing treatment-resistant schizophrenia. Combining clozapine with other antipsychotics (i.e., clozapine polypharmacy) has emerged as an option for clozapine-resistant schizophrenia. We aimed to investigate the factors associated with clozapine polypharmacy in schizophrenia patients discharged on clozapine from a public psychiatric hospital. The analysis included patients with schizophrenia who were discharged between 2006 and 2021 and prescribed clozapine upon discharge. All patients were divided into 2 groups: clozapin

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de Leon, Jose, Can-Jun Ruan, Hélène Verdoux, and Chuanyue Wang. "Clozapine is strongly associated with the risk of pneumonia and inflammation." General Psychiatry 33, no. 2 (2020): e100183. http://dx.doi.org/10.1136/gpsych-2019-100183.

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Clinicians need to remember that (1) systemic inflammations can increase clozapine level; (2) clozapine, by itself, can cause inflammation, particularly during titration that is too rapid for that patient; (3) clozapine may increase the risk of infection; and (4) more specifically, clozapine may be particularly strongly associated with the risk of pneumonia. Pneumonia appears to be associated with high mortality in clozapine patients around the world. Clinicians who are alert to the risk of pneumonia in clozapine patients may significantly decrease mortality in clozapine patients. There is no

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de Leon, Jose, Violet Henighan, Joseph K. Stanilla, and George M. Simpson. "Clozapine Levels After Clozapine Discontinuation." Journal of Clinical Psychopharmacology 16, no. 2 (1996): 193–94. http://dx.doi.org/10.1097/00004714-199604000-00016.

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lu, Hatice, i. kc, Canan l, and Yasemin ek. "Potential Indicators of Bone Marrow Suppression in Patients with Schizophrenia Receiving Clozapine: Platelet-Large Cell Ratio and Immature Granulocytes." Psychiatry and Behavioral Sciences 14, no. 4 (2024): 140. http://dx.doi.org/10.5455/pbs.20240301055535.

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Aim/background: The use of clozapine is restricted due to its serious side effects, particularly bone marrow suppression, which occurs at an average rate of 1%. These side effects are markedly related to blood concentrations of clozapine and its metabolite nor-clozapine. Therefore, therapeutic drug monitoring is recommended for clozapine. Currently, laboratory monitoring of bone marrow suppression includes neutrophil count follow-up. However, using early-changing biomarkers may be more effective in detecting and preventing this side effect before neutropenia develops. Therefore, we aimed to ev

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Buckley, Peter F., Philip Cola, Mitsuru Hasegawa, Christine Lys, and Paul Thompson. "Clozapine plasma levels and dosing strategies in patients with treatment-refractory schizophrenia." Irish Journal of Psychological Medicine 14, no. 3 (1997): 85–88. http://dx.doi.org/10.1017/s0790966700003165.

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AbstractObjective: To determine the effect on clinical response to clozapine of increasing the plasma levels of clozapine and its major metabolite N-desmethylclozapine in 19 patients with schizophrenia who had plasma clozapine levels ≤ 370ng/ml, a level previously determined to identify patients who were unlikely to have an adequate response to clozapine.Method: The dosage of clozapine was increased by 20% in 11 patients and left unaltered in the other eight patients. Clozapine and N-desmethylclozapine plasma levels were measured after six weeks at the higher dose.Results: Nine of the 11 patie

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Taylor, D., L. Shapland, G. Laverick, J. Bond, and J. Munro. "Clozapine – a survey of patient perceptions." Psychiatric Bulletin 24, no. 12 (2000): 450–52. http://dx.doi.org/10.1192/pb.24.12.450.

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Aims and MethodWe aimed to find out how patients on clozapine felt about clozapine treatment. A structured questionnaire was given to 1284 consecutive patients attending 27 clozapine clinics in the UK.ResultsThe response rate was 44.4% (570 forms returned). This cohort of responders to the questionnaire consisted, for the most part, of Caucasian males who had been taking clozapine for more than 2 years. Respondents expressed largely favourable views on clozapine treatment. For example, 86.1% claimed to feel better on clozapine and 88.6% claimed to prefer to remain on clozapine than to change t

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Jagota, Gopika, and Sandeep Grover. "Clozapine Withdrawal Catatonia: A Case Series and Review of Literature." Annals of Indian Psychiatry 8, no. 3 (2024): 246–54. http://dx.doi.org/10.4103/aip.aip_177_23.

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Background: Catatonia has been reported with withdrawal of medications. Among the various psychotropics, clozapine has been implicated to cause catatonia when abruptly withdrawn. The data regarding clozapine withdrawal catatonia are scarce and are mostly available in the form of case reports and series. Aim: In this case series, we present three cases of clozapine withdrawal catatonia and review the available literature on clozapine withdrawal clozapine. Results: All the three patients developed catatonia within 48 h to 14 days of stoppage of clozapine in the doses of 100–350 mg/day. Two of th

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Gessner, Brooke, Michelle Carter, Alberto Almeida, et al. "Clozapine clinical toolkit optimizes inpatient clozapine monitoring." Mental Health Clinician 14, no. 2 (2024): 85–91. http://dx.doi.org/10.9740/mhc.2024.04.085.

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Abstract Introduction Clozapine is the most effective antipsychotic in the management of treatment-resistant schizophrenia; however, its use is challenging due to the risk of severe adverse effects. Despite the risks associated with clozapine, there is no mandatory monitoring in Canada beyond hematologic testing for agranulocytosis surveillance. This study focuses on the development, implementation, and evaluation of a clozapine clinical toolkit (CTK) targeted at optimizing inpatient clozapine use. Methods A comprehensive literature review was conducted to identify clozapine best practices, ex

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Jakobsen, Michelle Iris, H. Grønborg, H. V. Hansen, and A. Fink-Jensen. "Clozapine-associated neutropenia following augmentation with sodium valproate." SAGE Open Medical Case Reports 9 (January 2021): 2050313X2110197. http://dx.doi.org/10.1177/2050313x211019791.

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Clozapine is gold standard for the management of treatment-resistant schizophrenia. It can offer life-changing symptom reduction where other antipsychotics have failed, and for these patients, treatment with clozapine should be maintained, if in any possible way. However, treatment with clozapine comes with a risk of developing potentially fatal adverse reactions, for example, severe neutropenia or agranulocytosis, in which case, treatment must be discontinued. Here, we present a case of clozapine-related neutropenia that commenced after the addition of sodium valproate. A subsequent re-challe

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Griffiths, Kira, Edward Millgate, Alice Egerton, and James H. MacCabe. "Demographic and clinical variables associated with response to clozapine in schizophrenia: a systematic review and meta-analysis." Psychological Medicine 51, no. 3 (2021): 376–86. http://dx.doi.org/10.1017/s0033291721000246.

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AbstractClozapine is the only licensed pharmacotherapy for treatment-resistant schizophrenia. However, response to clozapine is variable. Understanding the demographic and clinical features associated with response to clozapine may be useful for patient stratification for clinical trials or for identifying patients for earlier initiation of clozapine. We systematically reviewed the literature to investigate clinical and demographic factors associated with variation in clozapine response in treatment-resistant patients with schizophrenia spectrum disorders. Subsequently, we performed a random-e

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Stark, Anne, and James Scott. "A review of the use of clozapine levels to guide treatment and determine cause of death." Australian & New Zealand Journal of Psychiatry 46, no. 9 (2012): 816–25. http://dx.doi.org/10.1177/0004867412438871.

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Objective: To review the literature to examine the use of clozapine levels to (i) guide therapy and prevent toxicity in clinical care and (ii) determine cause of death in post-mortem examination of patients who were treated with clozapine. Methods: MEDLINE was searched in December 2010 using the following keywords: ‘clozapine levels’, ‘clozapine and toxicity’, ‘clozapine and death’, ‘clozapine and mortality’ and ‘post-mortem redistribution’. Data was also collected from the 2010 MIMS Annual. Results: The literature reported significant variation in clozapine levels attained with any given dose

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Goudie, Andrew J., Gillian D. Cooper, Jon C. Cole, and Harry R. Sumnall. "Cyproheptadine resembles clozapine in vivo following both acute and chronic administration in rats." Journal of Psychopharmacology 21, no. 2 (2007): 179–90. http://dx.doi.org/10.1177/0269881107067076.

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Cyproheptadine is a cheap, widely available anti-allergy drug with a broad receptor binding profile which resembles that of clozapine. In rats discriminating clozapine from vehicle cyproheptadine mimicked clozapine very closely. Acutely it induced full generalization in the absence of response suppression, as observed with clozapine. Chronic administration of clozapine and cyproheptadine induced tolerance and cross-tolerance respectively to the clozapine stimulus. This was characterized by circa 3.5-fold parallel shifts to the right in the clozapine generalization curves. Such tolerance and cr

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Chtibi, M., H. Zarouf, I. Hanine, S. Belbachir, and A. Ouanass. "Ultra-Resistant Schizophrenia Comorbid with Temporal Epilepsy: A Case Report." Scholars Journal of Medical Case Reports 11, no. 09 (2023): 1603–7. http://dx.doi.org/10.36347/sjmcr.2023.v11i09.009.

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Resistant schizophrenia is a significant public health issue due to high treatment costs and institutional dependence of patients. Despite the various definitions currently available to define resistant schizophrenia, along with existing clinical guidelines, their impact on daily clinical practice remains limited. While clozapine has been endorsed by national clinical guidelines, its utilization remains suboptimal, with delays in initiation and instances of ineffectiveness. Ultra-resistant schizophrenia is defined by clozapine's inefficacy even after a well-conducted treatment. The relationshi

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Bonany, J. Marti, E. Pérez Sánchez, M. Pérez Carre, et al. "Elevated clozapine levels in patients with COVID-19 infection." European Psychiatry 64, S1 (2021): S299. http://dx.doi.org/10.1192/j.eurpsy.2021.803.

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IntroductionClozapine is the most effective antipsychotic for treatment resistant schizophrenia. In patients treated with clozapine, COVID-19 infection may result in complications including an increased risk of pneumonia, clozapine toxicity, and disruption to clozapine treatment by COVID-19 induced lymphopenia.ObjectivesWe report 5 cases of elevated clozapine levels occurring in patients with COVID-19 infection who had been previously managed for several years on stable doses.MethodsSubjects: 48 admitted patients to a long-stay psychiatric unit. COVID-19 infection confirmed by positive nasopha

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