Duration of a Clozapine Trial in Neuroleptic-Resistant Schizophrenia

Meltzer, Herbert Y.

doi:10.1001/archpsyc.1989.01810070098017

Cited by 70 publications

(18 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Meltzer (1989b;1995b) has observed that some patients treated with clozapine may not reach criteria for response until after 6 months of treatment. Lieberman et al (1994) also noted that some patients continue to improve on clozapine for up to a year and has supported the idea that the optimal period for a trial of clozapine is 12 to 24 weeks.…”

Section: Discussionmentioning

confidence: 99%

Serotonin Subtype 2 Receptor Genes and Clinical Response to Clozapine in Schizophrenia Patients

Masellis

Basile

Meltzer

et al. 1998

Neuropsychopharmacology

227

135

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Serotonin Subtype 2 Receptor Genes and Clinical Response to Clozapine in Schizophrenia Patients

Masellis

Basile

Meltzer

et al. 1998

Neuropsychopharmacology

227

135

View full text Add to dashboard Cite

“…In addition, we might expect further symptomatic and functional improvement after a switch to generic clozapine if the medication was taken for less than six months, since this is generally accepted as the amount of time required for many treatment-resistant patients with schizophrenia to show substantial improvement. 65,66 Therapeutic equivalence results were difficult to combine because so few reports included validated measures of clinical symptoms, and, in instances where such measures were used, 48,52,61 no description of interrater reliability or rater blinding was provided. Several studies used proxy measures of clinical worsening, such as clozapine dosage changes and changes in utilization rates of psychiatric services.…”

Section: Patient Diagnosis Andmentioning

confidence: 99%

Converting from brand-name to generic clozapine: A review of effectiveness and tolerability data

Bobo

Stovall

Knostman³

et al. 2010

American Journal of Health-System Pharmacy

View full text Add to dashboard Cite

Available literature supports the effectiveness and safety of generic clozapine formulations in patients who previously were stable during treatment with brand-name clozapine. The risk of poor outcome after conversion to a generic clozapine formulation appears to be low but difficult to predict. Patients should be closely monitored during the first one to three months after conversion from one formulation to another.

show abstract

“…Bu eksikliklerin yanı sıra klozapine direnç ile ilgili iyi tanımlanmış belirli ölçütler henüz geliştirilmemiştir. Bazı yazarlar klozapin tedavisinin 6. ayı ile birinci yılı arasında tedaviye yanıt veren hastaları 'geç yanıt verenler' olarak tanımlamıştır (Meltzer 1989, Rosenheck ve ark. 1999; bu durum en azından kısmen bazı çalışmalardaki yanıtların plasebo etkisinden kaynaklanabileceğini de düşündürtmek-tedir.…”

Section: Discussionunclassified

Augmentation Strategies in Patients with Schizophrenia Who Show Partial Response to Clozapine Treatment

Vayısoğlu¹,

Yağcıoğlu²

2014

Turkish Journal of Psychiatry

View full text Add to dashboard Cite

ÖZETKlozapin tedavisi kullanan şizofreni hastalarının önemli bir oranı tedaviye kısmi yanıt vermektedir. Bu grup hastalarda klozapin tedavisine değişik psikotropların eklendiği güçlendirme yöntemleri ile ilgili bulgular çelişkilidir. Bu derlemede klozapin tedavisine dirençli şizofre-ni hastalarında güçlendirme ajanlarının etkinliği ve güvenliği ile ilgili yazın verileri gözden geçirilmiştir. Klozapini tedaviye dirençli şizofreni hastalarında güçlendirmek için kullanılan ek tedaviler antipsikotikler, antidepresanlar, duygudurum düzenleyicileri, diğer farmakolojik ajanlar (örneğin omega 3 yağ asitleri ve glutamaterjik tedaviler) ve elektrokonvulzif tedavi (EKT) olarak gruplanmıştır. Klozapinin tedaviye dirençli şizofreni hastalarında güçlendirilmesi ile ilgili en çok kontrollü çalışma-nın lamotrijin ve risperidon ile yapılmış olduğu görülmektedir. Ancak, meta analizler iki ajanın da klozapine eklenmesinin yararını desteklememektedir. Klozapinin amisülprid, aripiprazol, mirtazapin, omega 3 yağ asitleri ve EKT ile güçlendirilmesinin olumlu sonuç verdiğini destekleyen çalışmalar olsa da, delil/kanıt yeterli değildir ve ek araştırma-lara gereksinim vardır. Güncel çalışmalarda başlıca kısıtlılık, örneklem küçüklüğü, klozapine direnç tanımının sabit olmaması ve tanımlanmış sonlanım ölçütleri ile çalışma desenlerinin farklılık göstermesidir. Sonuç olarak, klozapin tedavisine dirençli şizofreni hastalarında tedavinin güç-lendirilmesi yöntemlerinin başarısı ile ilgili henüz yeterli kanıt yoktur.Anahtar Sözcükler: Şizofreni, klozapin, tedaviye direnç, güçlendirme tedavisi SUMMARY Augmentation Strategies in Patients with Schizophrenia Who Show Partial Response to Clozapine TreatmentA significant proportion of patients with schizophrenia receiving clozapine remain with partial response. In this group of patients findings regarding addition of various psychotropics to ongoing clozapine treatment for augmentation are controversial. In this review, literature regarding the efficacy and safety of adjunctive agents in clozapine resistant schizophrenic patients is examined. Augmentation agents added to clozapine in treatment resistant schizophrenic patients consist of antipsychotics, antidepressants, mood stabilizers, other agents (eg. omega 3 fatty acids and glutamatergic agents) and electroconvulsive therapy (ECT) in this review. The number of controlled studies evaluating augmentation of clozapine in schizophrenia patients are highest for risperidone and lamotrigine add on treatments. However, the results of recent meta-analyses studies do not support any benefit of either agent as adjunct to clozapine treatment. Some evidence regarding the success of clozapine augmentation with amisulpride, aripiprazole, mirtazapine, omega 3 fatty acids and ECT have been obtained which needs further clinical investigation. Current findings from relevant clinical studies point that theses studies have limitations of small sample size, variable definitions of clozapine resistance, heterogenity of outcome measures and methodological designs and th...

show abstract

Duration of a Clozapine Trial in Neuroleptic-Resistant Schizophrenia

Cited by 70 publications

References 6 publications

Serotonin Subtype 2 Receptor Genes and Clinical Response to Clozapine in Schizophrenia Patients

Serotonin Subtype 2 Receptor Genes and Clinical Response to Clozapine in Schizophrenia Patients

Converting from brand-name to generic clozapine: A review of effectiveness and tolerability data

Augmentation Strategies in Patients with Schizophrenia Who Show Partial Response to Clozapine Treatment

Contact Info

Product

Resources

About