Clozapine Management in Schizophrenia Inpatients: A 5-Year Prospective Observational Study of Its Safety and Tolerability Profile

Renato de Filippis,1 Raffaele Gaetano,1 Georgios Schoretsanitis,2 Giuseppe Verde,1 Cesare Anthony Oliveti,3 John M Kane,2,4,5 Cristina Segura-Garcia,6 Pasquale De Fazio1 1Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy; 2The Zucker Hillside Hos...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	de Filippis R, Gaetano R, Schoretsanitis G, Verde G, Oliveti CA, Kane JM, Segura-Garcia C, De Fazio P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	clozapine psychiatric care facilities safety schizophrenia tolerability treatment-resistant schizophrenia. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/036e476c5c7d4bd89f34c75873edfdb2
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:036e476c5c7d4bd89f34c75873edfdb2
record_format	dspace
spelling	oai:doaj.org-article:036e476c5c7d4bd89f34c75873edfdb22021-12-02T16:13:41ZClozapine Management in Schizophrenia Inpatients: A 5-Year Prospective Observational Study of Its Safety and Tolerability Profile1178-2021https://doaj.org/article/036e476c5c7d4bd89f34c75873edfdb22021-07-01T00:00:00Zhttps://www.dovepress.com/clozapine-management-in-schizophrenia-inpatients-a-5-year-prospective--peer-reviewed-fulltext-article-NDThttps://doaj.org/toc/1178-2021Renato de Filippis,1 Raffaele Gaetano,1 Georgios Schoretsanitis,2 Giuseppe Verde,1 Cesare Anthony Oliveti,3 John M Kane,2,4,5 Cristina Segura-Garcia,6 Pasquale De Fazio1 1Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy; 2The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA; 3Correnti - Centri Assistenziali Mons. Oliveti, Crotone, Italy; 4Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, USA; 5Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA; 6Psychiatry Unit, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, ItalyCorrespondence: Pasquale De FazioPsychiatry Unit, Department Health Sciences, University Magna Graecia of Catanzaro, Viale Europa 88100, Catanzaro, ItalyTel/Fax +39 0961 712393Email defazio@unicz.itBackground: Clozapine is well known for its efficacy and clinical superiority compared to other antipsychotics in treatment-resistant schizophrenia (TRS). However, it is frequently underutilized worldwide because of its acute adverse events, as well as for its long-term cardiometabolic and hematological consequences.Objective: The aim of the study was to evaluate 5-year safety in chronic TRS inpatients with continuous clozapine use.Methods: Patients with TRS and clozapine treatment were evaluated for 5 years. All participants were assessed using the Brief Psychiatric Rating Scale (BPRS), Glasgow Antipsychotic Side-effect Scale for Clozapine (GASS-C), Social Performance Scale (PSP) and Short Portable Mental Status Questionnaire (SPMSQ). Clinical, cardiometabolic and hematological data were collected periodically. General linear models (GLM) repeated measures controlling for CLZ dose were utilized to determine differences in variables across the time.Results: Overall, 189 inpatients were screened for study participation. The final sample included twenty-one TRS patients (16 males, 76%) with an average age of 57.6 years, all with 5-year continuous use of clozapine (mean dose 266 mg/day). There was not a significant effect of time on BPRS (p=0.774), PSP (p=0.855) and SPMSQ (p=0.066); differences remained not significant after controlling for CLZ dose (p=0.585, p=0.467 and p=0.105, respectively). No changes were found in blood and clinical parameters except for red blood cell count, which decreased over time (p=0.024; η2= 0.952). Patients reported a significant BMI decrease (− 8.98 kg, p=0.008) between baseline and 5 years last observation.Conclusion: The findings show how the application of a structured dietary, clinical and therapeutic monitoring program in psychiatric care facilities could allow the safe and effective long-term cardiometabolic and hematological management of clozapine. The unique role that clozapine plays in the current treatment of patients with TRS requires greater clinical awareness. Although its acute and chronic side effects are notorious, its safety management is feasible and broadens its potential practical application.Keywords: clozapine, psychiatric care facilities, safety, schizophrenia, tolerability, treatment-resistant schizophreniade Filippis RGaetano RSchoretsanitis GVerde GOliveti CAKane JMSegura-Garcia CDe Fazio PDove Medical Pressarticleclozapinepsychiatric care facilitiessafetyschizophreniatolerabilitytreatment-resistant schizophrenia.Neurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 17, Pp 2141-2150 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	clozapine psychiatric care facilities safety schizophrenia tolerability treatment-resistant schizophrenia. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	clozapine psychiatric care facilities safety schizophrenia tolerability treatment-resistant schizophrenia. Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 de Filippis R Gaetano R Schoretsanitis G Verde G Oliveti CA Kane JM Segura-Garcia C De Fazio P Clozapine Management in Schizophrenia Inpatients: A 5-Year Prospective Observational Study of Its Safety and Tolerability Profile
description	Renato de Filippis,1 Raffaele Gaetano,1 Georgios Schoretsanitis,2 Giuseppe Verde,1 Cesare Anthony Oliveti,3 John M Kane,2,4,5 Cristina Segura-Garcia,6 Pasquale De Fazio1 1Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy; 2The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA; 3Correnti - Centri Assistenziali Mons. Oliveti, Crotone, Italy; 4Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, USA; 5Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA; 6Psychiatry Unit, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, ItalyCorrespondence: Pasquale De FazioPsychiatry Unit, Department Health Sciences, University Magna Graecia of Catanzaro, Viale Europa 88100, Catanzaro, ItalyTel/Fax +39 0961 712393Email defazio@unicz.itBackground: Clozapine is well known for its efficacy and clinical superiority compared to other antipsychotics in treatment-resistant schizophrenia (TRS). However, it is frequently underutilized worldwide because of its acute adverse events, as well as for its long-term cardiometabolic and hematological consequences.Objective: The aim of the study was to evaluate 5-year safety in chronic TRS inpatients with continuous clozapine use.Methods: Patients with TRS and clozapine treatment were evaluated for 5 years. All participants were assessed using the Brief Psychiatric Rating Scale (BPRS), Glasgow Antipsychotic Side-effect Scale for Clozapine (GASS-C), Social Performance Scale (PSP) and Short Portable Mental Status Questionnaire (SPMSQ). Clinical, cardiometabolic and hematological data were collected periodically. General linear models (GLM) repeated measures controlling for CLZ dose were utilized to determine differences in variables across the time.Results: Overall, 189 inpatients were screened for study participation. The final sample included twenty-one TRS patients (16 males, 76%) with an average age of 57.6 years, all with 5-year continuous use of clozapine (mean dose 266 mg/day). There was not a significant effect of time on BPRS (p=0.774), PSP (p=0.855) and SPMSQ (p=0.066); differences remained not significant after controlling for CLZ dose (p=0.585, p=0.467 and p=0.105, respectively). No changes were found in blood and clinical parameters except for red blood cell count, which decreased over time (p=0.024; η2= 0.952). Patients reported a significant BMI decrease (− 8.98 kg, p=0.008) between baseline and 5 years last observation.Conclusion: The findings show how the application of a structured dietary, clinical and therapeutic monitoring program in psychiatric care facilities could allow the safe and effective long-term cardiometabolic and hematological management of clozapine. The unique role that clozapine plays in the current treatment of patients with TRS requires greater clinical awareness. Although its acute and chronic side effects are notorious, its safety management is feasible and broadens its potential practical application.Keywords: clozapine, psychiatric care facilities, safety, schizophrenia, tolerability, treatment-resistant schizophrenia
format	article
author	de Filippis R Gaetano R Schoretsanitis G Verde G Oliveti CA Kane JM Segura-Garcia C De Fazio P
author_facet	de Filippis R Gaetano R Schoretsanitis G Verde G Oliveti CA Kane JM Segura-Garcia C De Fazio P
author_sort	de Filippis R
title	Clozapine Management in Schizophrenia Inpatients: A 5-Year Prospective Observational Study of Its Safety and Tolerability Profile
title_short	Clozapine Management in Schizophrenia Inpatients: A 5-Year Prospective Observational Study of Its Safety and Tolerability Profile
title_full	Clozapine Management in Schizophrenia Inpatients: A 5-Year Prospective Observational Study of Its Safety and Tolerability Profile
title_fullStr	Clozapine Management in Schizophrenia Inpatients: A 5-Year Prospective Observational Study of Its Safety and Tolerability Profile
title_full_unstemmed	Clozapine Management in Schizophrenia Inpatients: A 5-Year Prospective Observational Study of Its Safety and Tolerability Profile
title_sort	clozapine management in schizophrenia inpatients: a 5-year prospective observational study of its safety and tolerability profile
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/036e476c5c7d4bd89f34c75873edfdb2
work_keys_str_mv	AT defilippisr clozapinemanagementinschizophreniainpatientsa5yearprospectiveobservationalstudyofitssafetyandtolerabilityprofile AT gaetanor clozapinemanagementinschizophreniainpatientsa5yearprospectiveobservationalstudyofitssafetyandtolerabilityprofile AT schoretsanitisg clozapinemanagementinschizophreniainpatientsa5yearprospectiveobservationalstudyofitssafetyandtolerabilityprofile AT verdeg clozapinemanagementinschizophreniainpatientsa5yearprospectiveobservationalstudyofitssafetyandtolerabilityprofile AT olivetica clozapinemanagementinschizophreniainpatientsa5yearprospectiveobservationalstudyofitssafetyandtolerabilityprofile AT kanejm clozapinemanagementinschizophreniainpatientsa5yearprospectiveobservationalstudyofitssafetyandtolerabilityprofile AT seguragarciac clozapinemanagementinschizophreniainpatientsa5yearprospectiveobservationalstudyofitssafetyandtolerabilityprofile AT defaziop clozapinemanagementinschizophreniainpatientsa5yearprospectiveobservationalstudyofitssafetyandtolerabilityprofile
_version_	1718384330566270976

Clozapine Management in Schizophrenia Inpatients: A 5-Year Prospective Observational Study of Its Safety and Tolerability Profile

Ejemplares similares