Involuntary treatment of schizophrenia patients 2004–2010 in <scp>D</scp>enmark

Andersen, Trine Borup; Kappers, Daniel; Sneider, Benjamin; Uggerby, Peter; Nielsen, Jimmi

doi:10.1111/acps.12144

Cited by 12 publications

(3 citation statements)

References 44 publications

(47 reference statements)

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“…Another survey found that approximately 40% of psychiatrists did not attempt switching patients from APP to antipsychotic monotherapy . Since clozapine is a more evidence-based treatment option than APP, more should be done to ensure that treatment follows treatment guidelines and clozapine should be attempted before using APP if used to target poor therapeutic response (Andersen et al, 2014). More should be done to equip psychiatrists on how to switch from APP to antipsychotic monotherapy.…”

Section: Discussionmentioning

confidence: 99%

Frequency and correlates of antipsychotic polypharmacy among patients with schizophrenia in Denmark: A nation-wide pharmacoepidemiological study

Sneider

Pristed

Correll

et al. 2015

European Neuropsychopharmacology

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Section: Discussionmentioning

confidence: 99%

Frequency and correlates of antipsychotic polypharmacy among patients with schizophrenia in Denmark: A nation-wide pharmacoepidemiological study

Sneider

Pristed

Correll

et al. 2015

European Neuropsychopharmacology

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“…This study used the assumption that patients did not have any symptoms of MI because they did not receive treatment. However, some patients may have had symptoms but did not seek treatment because they may have been afraid of using the healthcare system – for example, due to risk of involuntary admission (28). On the other hand, patients with schizophrenia may have experienced the symptoms but interpreted them in a psychotic context, such as radiation from outer space.…”

Section: Discussionmentioning

confidence: 99%

Unrecognised myocardial infarction in patients with schizophrenia

Nielsen

Juel

Alzuhairi

et al. 2015

Acta Neuropsychiatr.

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“…In a survey of 39 British psychiatrists, 6 reported enforcing intramuscular medication each time oral clozapine was refused [ 11 ]. In a register-based study from Denmark, it was reported that 2 patients with schizophrenia were receiving intramuscular clozapine involuntarily during a studied period [ 37 ].…”

Section: Reviewmentioning

confidence: 99%

Clinical Experience With Intramuscular Clozapine

Munzar¹,

Nemets²

2021

Cureus

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Clozapine is the most effective antipsychotic for patients with treatment-refractory schizophrenia, but many refuse to accept oral clozapine therapy. Intramuscular (IM) clozapine represents a convenient alternative for their treatment. The aim of this review is to summarize studies investigating IM clozapine administration. When initially developed, clozapine was also provided as an IM formulation, but the manufacturer later discontinued its production. Recently, IM clozapine became again available as an unlicensed product distributed by the Dutch company Apotheek A15. The use of IM clozapine has been reported in older studies on clozapine’s adverse effects. It has also been described in detail in 5 more recent and generally smaller (n = 7 - 59) retrospective studies in patients refusing to take oral clozapine. In addition, its administration has been noted in 5 case reports. IM clozapine has been used at approximately ½ of the dose of oral clozapine due to pharmacokinetic considerations. It has been used in doses of up to 500 mg per day and for up to 99 days of treatment. The majority of patients (between 60 and 100%) were successfully transitioned to oral clozapine within a few days of IM treatment, and improvement in their condition was sustained during the long-term follow-up. Side effects of IM clozapine were similar to those of oral clozapine, but its sedative and cardiovascular effects (hypotension and tachycardia) had faster onset following IM administration. After long-term use, clozapine injections lead to local swelling and to the formation of painful nodules in some patients. In summary, IM clozapine may facilitate successful transition to oral clozapine in most patients, and it definitely represents a valuable tool for addressing refusal of oral clozapine in patients with treatment-refractory schizophrenia. More studies, especially focused on its safety, are, however, needed to better understand the limitations of this novel treatment approach.

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Involuntary treatment of schizophrenia patients 2004–2010 in Denmark

Abstract: Involuntary treatment involved a wide range of somatic treatment. Antipsychotic medicine was the most common psychotropic used. Involuntary treatment with depot antipsychotics and clozapine were rare.

Cited by 12 publications

References 44 publications

Frequency and correlates of antipsychotic polypharmacy among patients with schizophrenia in Denmark: A nation-wide pharmacoepidemiological study

Frequency and correlates of antipsychotic polypharmacy among patients with schizophrenia in Denmark: A nation-wide pharmacoepidemiological study

Unrecognised myocardial infarction in patients with schizophrenia

Clinical Experience With Intramuscular Clozapine

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