The safety of clozapine in the elderly

Gareri, Pietro; Fazio, Pasquale De; Russo, Emilio; Marigliano, Norma; Fazio, Salvatore De; Sarro, Giovambattista De

doi:10.1517/14740338.7.5.525

Cited by 54 publications

(42 citation statements)

References 76 publications

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“…Other side effects, such as sedation, hypotension, weight gain, agitation, increase of blood glucose and lipid level, were detected in this research. This finding is in accordance with other researchers in this field [11][12][13]. Watchful monitoring of side effects of clozapine used in elderly is unevitable [12,13].…”

Section: Discussionsupporting

confidence: 93%

“…However, clozapine is associated with many serious side effects which should be taken into account -such as severe and potentially lethal neutropenia, eosinophilia, seizures, myocarditis, weight gain, diabetes, metabolic syndrome, hypersalivation, fever, constipation, ileus, urinary incontinence, sweating [11]. There are no contraindications for using clozapine in elderly, however, clozapine treatment in the elderly requires a careful geriatric assessment [12]. Clozapine used in elderly at a relatively low mean dose seems to be safe, tolerated, and effective, agranulocytosis is more frequent than in younger adults and should be monitored carefully [12,13].…”

Section: Intoductionmentioning

confidence: 99%

“…There are no contraindications for using clozapine in elderly, however, clozapine treatment in the elderly requires a careful geriatric assessment [12]. Clozapine used in elderly at a relatively low mean dose seems to be safe, tolerated, and effective, agranulocytosis is more frequent than in younger adults and should be monitored carefully [12,13].…”

Section: Intoductionmentioning

confidence: 99%

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Clozapine for Treating Pharmacoresistant Schizophrenia among Elders

Luzny¹,

Chalany²

2014

J Clin Diagn Res

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Introduction: Pharmacoresistant schizophrenia is not a rarity. It is defined as un successfull treatment of schizophrenia by two different sort of antipsychotics with different mechanism of action, lasting up at least six weeks with dosage which is equivalent to 1000 mg per day of chlorpromazine in the period of last five years. Clozapine is used as a "rescue"antipsychotic when previous treatment of schizophrenia fails.Objective of the study is to examine safety and effectiveness of clozapine in treating pharmacoresistant schizophrenia among elders.

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Section: Discussionsupporting

confidence: 93%

Section: Intoductionmentioning

confidence: 99%

Section: Intoductionmentioning

confidence: 99%

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Clozapine for Treating Pharmacoresistant Schizophrenia among Elders

Luzny¹,

Chalany²

2014

J Clin Diagn Res

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“…Antipsychotic drugs (APs) can be of great benefit in several psychiatric disorders, including schizophrenia and bipolar disorder, although they are all associated with different adverse effects such as oversedation, neuroleptic malignant syndrome, extrapyramidal symptoms, tardive dyskinesia, anticholinergic symptoms, and seizures [1][2][3][4][5][6]. Most neuroleptics can lower seizure threshold and increase the chance of seizure occurrence [3,[7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of the Treatment of Chronic Antipsychotic Drugs on Epileptic Susceptibility in Genetically Epilepsy-prone Rats

et al. 2015

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Antipsychotic drugs (APs) are of great benefit in several psychiatric disorders, but they can be associated with various adverse effects, including seizures. To investigate the effects of chronic antipsychotic treatment on seizure susceptibility in genetically epilepsy-prone rats, some APs were administered for 7 weeks, and seizure susceptibility (audiogenic seizures) was evaluated once a week during treatment and for 5 weeks after drug withdrawal. Furthermore, acute and subchronic (5-day treatment) effects were also measured. Rats received haloperidol (0.2-1.0 mg/kg), clozapine (1-5 mg/kg), risperidone (0.03-0.50 mg/kg), quetiapine (2-10 mg/kg), aripriprazole (0.2-1.0 mg/kg), and olanzapine (0.13-0.66 mg/kg), and tested according to treatment duration. Acute administration of APs had no effect on seizures, whereas, after regular treatment, aripiprazole reduced seizure severity; haloperidol had no effects and all other APs increased seizure severity. In chronically treated rats, clozapine showed the most marked proconvulsant effects, followed by risperidone and olanzapine. Quetiapine and haloperidol had only modest effects, and aripiprazole was anticonvulsant. Finally, the proconvulsant effects lasted at least 2-3 weeks after treatment suspension; for aripiprazole, a proconvulsant rebound effect was observed. Taken together, these results indicate and confirm that APs might have the potential to increase the severity of audiogenic seizures but that aripiprazole may exert anticonvulsant effects. The use of APs in patients, particularly in patients with epilepsy, should be monitored for seizure occurrence, including during the time after cessation of therapy. Further studies will determine whether aripiprazole really has a potential as an anticonvulsant drug and might also be clinically relevant for epileptic patients with psychiatric comorbidities.

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“…Por otro lado, la mayoría de los estudios farmacológi-cos se centran en población joven, haciendo que las alternativas terapéuticas en el adulto mayor sean extremadamente limitadas. En general, las recomendaciones que se realizan a los clínicos es de un uso de psicofármacos con cautela 19 , que si bien es válida desde varios puntos de vista, también es válido reconocer que existen limitaciones a la posibilidad de determinar el comportamiento de ciertos agentes en población de edad avanzada, los cuales eventualmente serían de ayuda.…”

Section: Discussionunclassified

¿La exposición a clozapina en el adulto mayor está asociada a riesgo de leucopenia?

Villanueva-Esparza

2018

Rev. chil. neuro-psiquiatr.

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The safety of clozapine in the elderly

Cited by 54 publications

References 76 publications

Clozapine for Treating Pharmacoresistant Schizophrenia among Elders

Clozapine for Treating Pharmacoresistant Schizophrenia among Elders

Comparative Analysis of the Treatment of Chronic Antipsychotic Drugs on Epileptic Susceptibility in Genetically Epilepsy-prone Rats

¿La exposición a clozapina en el adulto mayor está asociada a riesgo de leucopenia?

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