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Long-term sustained benefits of clozapine treatment in refractory early onset schizophrenia: a retrospective study in Korean children and adolescents

Cited 17 time in Web of Science Cited 20 time in Scopus
Authors
Kim, Yeni; Kim, Boong-Nyun; Cho, Soo-Churl; Kim, Jae-Won; Shin, Min-Sup
Issue Date
2008-09-25
Publisher
Wiley-Blackwell
Citation
Hum Psychopharmacol. 2008 ;23(8):715-22.
Keywords
AdolescentAge of OnsetAntipsychotic Agents/*administration & dosage/adverse effects/*therapeutic useAsian Continental Ancestry GroupClozapine/*administration & dosage/adverse effects/*therapeutic useDose-Response Relationship, DrugDrug ResistanceFemaleHospitalization/statistics & numerical dataHumansKorea/epidemiologyLength of StayMaleNeutropenia/blood/chemically induced/epidemiologyPsychiatric Status Rating ScalesRetrospective StudiesSchizophrenia/*drug therapySchizophrenic PsychologyTime FactorsTreatment Outcome
Abstract
OBJECTIVE: Treatment resistance in early onset schizophrenia (EOS) is one of the most challenging problems in child and adolescent psychiatry. We retrospectively examined the therapeutic dosage, clinical response, and side effect profiles of long-term clozapine treatment in Korean children and adolescents with refractory EOS or very early onset schizophrenia (VEOS). METHOD: 26 refractory patients treated with clozapine for more than 1 year were analyzed. Efficacy was determined by comparing hospitalization rate and duration, before and after clozapine treatment. Tolerability was assessed through review of documented adverse events. RESULTS: A significant reduction in hospital days per year was observed in 25 (96.2%) patients after clozapine treatment compared to before clozapine. Long-term benefit of the treatment was supported by a further reduction of the hospitalization rate in 14 patients treated with clozapine for more than 3 years. Neutropenia developed in 26.9% patients at 1 year and there was no agranulocytosis. Overall, eight male patients (8/12, 66.7%) and one female patient (1/14, 7%) developed neutropenia and out of the nine patients, seven patients were maintained and two patients were successfully rechallenged on clozapine. CONCLUSION: These findings suggest that long-term clozapine treatment may effectively reduce the amount of time Asian patients with refractory EOS or VEOS spend in the hospital. However careful monitoring of adverse events is required.
ISSN
1099-1077 (Electronic)
0885-6222 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18814190

https://hdl.handle.net/10371/63326
DOI
https://doi.org/10.1002/hup.982
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College of Medicine/School of Medicine (의과대학/대학원)Psychiatry (정신과학전공)Journal Papers (저널논문_정신과학전공)
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