Proactive Modification to Clozapine Dose in a Patient With Pneumonia to Prevent Toxicity

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Betsy D. McCollum ◽  
Paige K. Juettner ◽  
Charles I. Shelton
Keyword(s):  
Clozapine Dose

Side Effects of Clozapine and Their Relationship with Clinical Variables in Patients with Schizophrenia

2017 ◽  
Vol 41 (S1) ◽  
pp. S197-S197
Author(s):  
G. Gürcan ◽  
Ş. Hun Şenol ◽  
A.E. Anıl Yağcıoğlu ◽  
A. Ertuğrul
Keyword(s):  
Metabolic Syndrome ◽  
Side Effects ◽  
Plasma Levels ◽  
Rating Scale ◽  
Clinical Status ◽  
Clinical Variables ◽  
Clozapine Treatment ◽  
Clozapine Dose ◽  
Severity Of Disability ◽  
Competing Interest

IntroductionThe side effects of clozapine may affect the treatment process negatively, and increase the disability.AimsWe aimed to assess the side effects of clozapine, and their relationship with the clinical variables in schizophrenia patients, and study the predictors of disability.MethodsConsecutive 122 outpatients who met DSM-IV criteria for schizophrenia, and were on clozapine treatment were included in the study. Information about sociodemographic characteristics, past and current clinical status were gathered through a clinical interview and review of the medical records, and physical measures and laboratory tests, including clozapine plasma levels, were recorded. The patients were assessed with SCID-I, Positive and Negative Syndrome Scale, UKU-Side Effect Rating Scale, WHO-Disability Assessment Schedule-II.ResultsHypersalivation, weight gain, sedation and constipation were the most common side effects of clozapine. Although the mean plasma clozapine levels were high (828.11 ± 445.5 ng/mL), no significant effect of clozapine dose and plasma levels were detected on the severity of side effects, except for constipation. Metabolic syndrome prevalence was found to be 50% according to ATP IIIA criteria. Duration of clozapine treatment, clozapine dose and plasma levels were not significantly different between patients with and without metabolic syndrome. Regression analysis showed that the severity of schizophrenia psychopathology and the number of side effects predicted the severity of disability.ConclusionsSide effects of clozapine increase the disability of patients with schizophrenia and should be monitored regularly. On the other hand, clozapine dose and plasma levels do not determine the severity of most of the common side effects.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Tardive dyskinesia with clozapine dose reduction or withdrawal dyskinesia?

2011 ◽  
Vol 43 (1) ◽  
pp. 93 ◽  
Author(s):  
SamirKumar Praharaj
Keyword(s):  
Tardive Dyskinesia ◽  
Dose Reduction ◽  
Clozapine Dose

scholarly journals Successful rechallenge with paliperidone after clozapine treatment for a patient with dopamine supersensitivity psychosis

2020 ◽  
Vol 8 ◽  
pp. 2050313X2092956
Author(s):  
Remiko Kobayashi ◽  
Yasunori Oda ◽  
Ryunosuke Hayatsu ◽  
Nozomi Ohki ◽  
Misa Akutsu ◽  
...  
Keyword(s):  
Symptomatic Relief ◽  
Psychotic Symptoms ◽  
Psychotic Episode ◽  
Antipsychotic Treatment ◽  
Treatment Resistant ◽  
Clozapine Treatment ◽  
Clozapine Dose ◽  
Japanese Male ◽  
Old Japanese ◽  
Dopamine Supersensitivity

We describe the case of a 49-year-old Japanese male patient successfully treated with a paliperidone rechallenge following 2-year treatment with clozapine for treatment-resistant schizophrenia. He had responded well to conventional antipsychotic treatment for the initial psychotic episode but gradually developed dopamine supersensitivity; even treatment with paliperidone and another antipsychotic medication (a total up to 1700 mg in chlorpromazine-equivalent dose) had not improved his psychotic symptoms. Clozapine treatment produced temporary symptomatic relief, but the clozapine dose could not be increased to > 150 mg due to the patient’s intolerance. Following low-dose clozapine treatment for 2 years, a rechallenge with paliperidone monotherapy ameliorated his psychotic symptoms. This suggests that clozapine may have the potential to release the dopamine supersensitivity state. Our patient’s case indicates that for patients with dopamine supersensitivity psychosis, a rechallenge with a previously ineffective antipsychotic after clozapine treatment may be successful.

scholarly journals Do Asian Patients Require Only Half of the Clozapine Dose Prescribed for Caucasians? A Critical Overview

2020 ◽  
Vol 42 (1) ◽  
pp. 4-10 ◽  
Author(s):  
Jose de Leon ◽  
Anto P. Rajkumar ◽  
Arun R. Kaithi ◽  
Georgios Schoretsanitis ◽  
John M. Kane ◽  
...  
Keyword(s):  
Asian Patients ◽  
Clozapine Dose ◽  
Critical Overview

1763 – Effectiveness and safety of rapid clozapine dose titration

2013 ◽  
Vol 28 ◽  
pp. 1 ◽  
Author(s):  
P. Ifteni ◽  
P. Manu
Keyword(s):  
Dose Titration ◽  
Clozapine Dose

Fluvoxamine—Clozapine Dose-Dependent Interaction

1996 ◽  
Vol 41 (10) ◽  
pp. 670-671 ◽  
Author(s):  
John S Markowitz ◽  
Harry S Gill ◽  
Maria Lavia ◽  
Timothy D Brewerton ◽  
C Lindsay DeVane
Keyword(s):  
Clozapine Dose ◽  
Dose Dependent ◽  
Dependent Interaction

scholarly journals A Low Clozapine Dose Improved Refractory Tardive Dystonia without Exacerbating Psychiatric Symptoms: A Case Report

2021 ◽  
Vol Volume 14 ◽  
pp. 237-239
Author(s):  
Naomichi Okamoto ◽  
Yuki Konishi ◽  
Hirofumi Tesen ◽  
Atsuko Ikenouchi ◽  
Reiji Yoshimura
Keyword(s):  
Case Report ◽  
Psychiatric Symptoms ◽  
Tardive Dystonia ◽  
Clozapine Dose

Prevalence and nature of side effects during clozapine maintenance treatment and the relationship with clozapine dose and plasma concentration

2007 ◽  
Vol 22 (4) ◽  
pp. 238-243 ◽  
Author(s):  
Babur Yusufi ◽  
Sujoy Mukherjee ◽  
Robert Flanagan ◽  
Carol Paton ◽  
Graham Dunn ◽  
...  
Keyword(s):  
Plasma Concentration ◽  
Side Effects ◽  
Maintenance Treatment ◽  
Clozapine Dose ◽  
The Relationship

scholarly journals Changes in smoking status, mental state and plasma clozapine concentration: retrospective cohort evaluation

2019 ◽  
Vol 43 (6) ◽  
pp. 271-274
Author(s):  
Inti Qurashi ◽  
Paul Stephenson ◽  
Chitra Nagaraj ◽  
Simon Chu ◽  
Richard Drake ◽  
...  
Keyword(s):  
Mental State ◽  
Retrospective Cohort ◽  
Dosage Adjustment ◽  
Smoking Status ◽  
Serum Levels ◽  
Clinical Implications ◽  
Clozapine Concentration ◽  
Clozapine Dose ◽  
Forensic Psychiatric ◽  
Almost All

Aims and methodTo investigate the percentage of patients who commenced smoking after transferring out of a non-smoking forensic psychiatric unit, the corresponding clozapine dose adjustments, the effects on plasma clozapine/norclozapine concentrations and observed changes in mental state. We reviewed the notes and plasma clozapine/norclozapine concentrations of 46 patients transferred to medium secure units between July 2008 and December 2013.ResultsThirty-five patients commenced smoking. Their median clozapine dose was increased by 50 mg/d. In the non-smokers, the median clozapine dose remained unchanged. Plasma clozapine/norclozapine concentrations were significantly reduced in smokers despite dosage adjustment. Eighteen patients experienced deterioration in mental state after transfer; almost all these patients were smokers.Clinical implicationsApproximately three-quarters of patients who were non-smokers by virtue of being in a secure non-smoking environment commenced smoking after transfer. Monitoring of clozapine serum levels and assessment of mental state in the immediate period after a change in smoking status is indicated.

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