Comparison of hospitalisation time of schizophrenic patients exposed and not exposed to therapeutic drug monitoring of clozapine

Clozapine is the most effective antipsychotic drug for the treatment of schizophrenia, but unfortunately its safety profile constrains it to last resort treatment. Moreover, this cul-de-sac is filled with obstacles that make clozapine the most challenging psychotropic drug to prescribe. Hopefully, optimisation of clozapine treatment can be achieved in multiple ways, one of which is therapeutic drug monitoring (TDM). Multiple studies have shown a link between a clozapine blood concentration threshold of 350 ng/mL and improved clinical response. However, no research has been done on the effectiveness of TDM as a tool to optimize clozapine treatment. Our hypothesis was that TDM could shorten clozapine titration time, thereby decreasing hospitalisation length.

Evaluating the Effect of Concomitant Medications With Clozapine

This study replicated and expanded a previous retrospective chart review conducted at Buffalo Psychiatric Center examining the impact of medication co-administration with clozapine patients for a significantly larger sample. Assuring the proper identification of problematic medication combinations with clozapine may minimize interruption/cessation of clozapine therapy.

A Cross Country Study of The Effect of Three Dibenzodiazepines: Clozapine, Quetiapine And Olanzepine On Thyroid Function In Patients With Schizophrenia

Thyroid function is very important in psychiatric disorders. Thyroid plays very important role in disease states such as schizophrenia and mood disorders. Atypical antipsychotics including dibenzodiazepines class often used as the first line agent to treat schizophrenia or schizoaffective disorders. Based on several case reports, clozapine, quetiapine and olanzepine are found to decrease thyroid hormone, TT4, FT4 and FT3. This can complicate psychiatric treatment regimen and delay the disease recovery process.

TREATMENT OF SCHIZOPHRENIA AND CO-MORBID DIPHENHYDRAMINE DEPENDENCE WITH CLOZAPINE: A CASE REPORT

Diphenhydramine, an antihistamine medication, is used for allergic reactions and can be found in sleep-promoting products. At high doses, it can cause paradoxical insomnia, agitation and hallucinations. Diphenhydramine has a high abuse potential, hypothesized to mimic cocaine in the brain. Patients with psychotic disorders are at higher risk of abusing substances, including diphenhydramine and alcohol. Studies have shown that clozapine, an atypical antipsychotic, may help decrease the abuse of substances in patients with psychotic disorders.

MMN responsivity to manipulations of frequency and duration deviants in chronic, clozapine-treated schizophrenia patients.

Horton J, Millar A, Labelle A, Knott VJ. MMN responsivity to manipulations of frequency and duration deviants in chronic, clozapine-treated schizophrenia patients. Schizophrenia Res. 2011;126(1-3):202-11. DOI: 10.1016/j.schres.2010.11.028. PubMed PMID: 21194893.

Adolescent with treatment-refractory schizophrenia and clozapine-induced cardiomyopathy managed with high-dose olanzapine.

Bobb VT, Jarskog LF, Coffey BJ. Adolescent with treatment-refractory schizophrenia and clozapine-induced cardiomyopathy managed with high-dose olanzapine. J Child Adolesc Psychopharmacol. 2010;20(6):539-43. DOI: 10.1089/cap.2010.2062. PubMed PMID: 21186975.

The atypical anti-psychotic clozapine decreases bone mass in rats in vivo.

Costa JL, Smith G, Watson M, Lin J-M, Callon K, Gamble G, et al. The atypical anti-psychotic clozapine decreases bone mass in rats in vivo. Schizophrenia Res. 2011;126(1-3):291-7. DOI: 10.1016/j.schres.2010.11.024. PubMed PMID: 21185156.

Association between HTR2C polymorphisms and metabolic syndrome in patients with schizophrenia treated with atypical antipsychotics.

Bai YM, Chen T-T, Liou Y-J, Hong C-J, Tsai S-J. Association between HTR2C polymorphisms and metabolic syndrome in patients with schizophrenia treated with atypical antipsychotics. Schizophrenia Res. 2011;125(2-3):179-86. DOI: 10.1016/j.schres.2010.11.030. PubMed PMID: 21185157.

The long-term effectiveness of clozapine and lamotrigine in a patient with treatment-resistant rapid-cycling bipolar disorder.

Bastiampillai TJ, Reid CE, Dhillon R. The long-term effectiveness of clozapine and lamotrigine in a patient with treatment-resistant rapid-cycling bipolar disorder. J Psychopharmacol. 2010;24(12):1834-6. DOI: 10.1177/0269881109358202. PubMed PMID: 20142304.

The metabolic syndrome and its constituting variables in atypical antipsychotic-treated subjects: comparison with other drug treatments, drug-free psychiatric patients, first-degree relatives and the general population in Venezuela.

Baptista T, Serrano A, Uzcátegui E, ElFakih Y, Rangel N, Carrizo E, et al.. The metabolic syndrome and its constituting variables in atypical antipsychotic-treated subjects: comparison with other drug treatments, drug-free psychiatric patients, first-degree relatives and the general population in Venezuela. Schizophrenia Res. 2011;126(1-3):93-102. DOI: 10.1016/j.schres.2010.10.014. PubMed PMID: 21071179.