Clozapine-induced seizures, electroencephalography abnormalities, and clinical responses in Japanese patients with schizophrenia

Yuka Sugawara Kikuchi, Wataru Sato, Keiichiro Ataka, Kiwamu Yagisawa, Yuki Omori, Takashi Kanbayashi, Tetsuo Shimizu Department of Neuropsychiatry, Akita University Graduate School of Medicine, Hondo, Akita, Japan Purpose: We describe electroencephalography (EEG) abnormalities and seizures associ...

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Autores principales:	Kikuchi YS, Sato W, Ataka K, Yagisawa K, Omori Y, Kanbayashi T, Shimizu T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/aebe2598d94e4a1bbca0cbf843885024
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spelling	oai:doaj.org-article:aebe2598d94e4a1bbca0cbf8438850242021-12-02T02:46:47ZClozapine-induced seizures, electroencephalography abnormalities, and clinical responses in Japanese patients with schizophrenia1178-2021https://doaj.org/article/aebe2598d94e4a1bbca0cbf8438850242014-10-01T00:00:00Zhttp://www.dovepress.com/clozapine-induced-seizures-electroencephalography-abnormalities-and-cl-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021 Yuka Sugawara Kikuchi, Wataru Sato, Keiichiro Ataka, Kiwamu Yagisawa, Yuki Omori, Takashi Kanbayashi, Tetsuo Shimizu Department of Neuropsychiatry, Akita University Graduate School of Medicine, Hondo, Akita, Japan Purpose: We describe electroencephalography (EEG) abnormalities and seizures associated with clozapine treatment in Japanese patients with schizophrenia and retrospectively compare EEG results and total Positive and Negative Syndrome Scale (PANSS [T]) scores before and after treatment. Methods: Twenty-six patients with treatment-resistant schizophrenia were enrolled in this study. EEG measurements were obtained prior to clozapine treatment and every 4 weeks thereafter. EEG measurements were also obtained at the time of seizure. After seizures or EEG abnormalities were noted, additional EEGs were performed every 2 weeks. PANSS (T) scores were used to determine clozapine treatment outcome. Results: All 26 patients had normal baseline EEG measurements, and ten patients (38.5%) later manifested EEG abnormalities. The mean age was significantly lower than in the abnormal EEG group. Six patients (23.1%) experienced seizures. The mean dose of clozapine at the first occurrence of seizure was 383.3 mg/day. Five of six patients who experienced seizures in this study were successfully treated with valproate or lamotrigine without discontinuation of clozapine. The one patient who continued to experience seizures was successfully treated without antiepileptic drugs. The mean baseline PANSS (T) scores were not significantly different between the normal and abnormal EEG groups, but the mean score in the abnormal EEG group was significantly lower than that in the normal EEG group at the final follow-up (P=0.02). Conclusion: EEG abnormalities may appear in younger patients, and our findings indicate that there is no need to discontinue clozapine when seizures occur. EEG abnormalities that appeared after clozapine treatment were associated with a good clinical response. Keywords: treatment-resistant schizophrenia, side effects, PANSS, convulsionsKikuchi YSSato WAtaka KYagisawa KOmori YKanbayashi TShimizu TDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2014, Iss default, Pp 1973-1978 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Kikuchi YS Sato W Ataka K Yagisawa K Omori Y Kanbayashi T Shimizu T Clozapine-induced seizures, electroencephalography abnormalities, and clinical responses in Japanese patients with schizophrenia
description	Yuka Sugawara Kikuchi, Wataru Sato, Keiichiro Ataka, Kiwamu Yagisawa, Yuki Omori, Takashi Kanbayashi, Tetsuo Shimizu Department of Neuropsychiatry, Akita University Graduate School of Medicine, Hondo, Akita, Japan Purpose: We describe electroencephalography (EEG) abnormalities and seizures associated with clozapine treatment in Japanese patients with schizophrenia and retrospectively compare EEG results and total Positive and Negative Syndrome Scale (PANSS [T]) scores before and after treatment. Methods: Twenty-six patients with treatment-resistant schizophrenia were enrolled in this study. EEG measurements were obtained prior to clozapine treatment and every 4 weeks thereafter. EEG measurements were also obtained at the time of seizure. After seizures or EEG abnormalities were noted, additional EEGs were performed every 2 weeks. PANSS (T) scores were used to determine clozapine treatment outcome. Results: All 26 patients had normal baseline EEG measurements, and ten patients (38.5%) later manifested EEG abnormalities. The mean age was significantly lower than in the abnormal EEG group. Six patients (23.1%) experienced seizures. The mean dose of clozapine at the first occurrence of seizure was 383.3 mg/day. Five of six patients who experienced seizures in this study were successfully treated with valproate or lamotrigine without discontinuation of clozapine. The one patient who continued to experience seizures was successfully treated without antiepileptic drugs. The mean baseline PANSS (T) scores were not significantly different between the normal and abnormal EEG groups, but the mean score in the abnormal EEG group was significantly lower than that in the normal EEG group at the final follow-up (P=0.02). Conclusion: EEG abnormalities may appear in younger patients, and our findings indicate that there is no need to discontinue clozapine when seizures occur. EEG abnormalities that appeared after clozapine treatment were associated with a good clinical response. Keywords: treatment-resistant schizophrenia, side effects, PANSS, convulsions
format	article
author	Kikuchi YS Sato W Ataka K Yagisawa K Omori Y Kanbayashi T Shimizu T
author_facet	Kikuchi YS Sato W Ataka K Yagisawa K Omori Y Kanbayashi T Shimizu T
author_sort	Kikuchi YS
title	Clozapine-induced seizures, electroencephalography abnormalities, and clinical responses in Japanese patients with schizophrenia
title_short	Clozapine-induced seizures, electroencephalography abnormalities, and clinical responses in Japanese patients with schizophrenia
title_full	Clozapine-induced seizures, electroencephalography abnormalities, and clinical responses in Japanese patients with schizophrenia
title_fullStr	Clozapine-induced seizures, electroencephalography abnormalities, and clinical responses in Japanese patients with schizophrenia
title_full_unstemmed	Clozapine-induced seizures, electroencephalography abnormalities, and clinical responses in Japanese patients with schizophrenia
title_sort	clozapine-induced seizures, electroencephalography abnormalities, and clinical responses in japanese patients with schizophrenia
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/aebe2598d94e4a1bbca0cbf843885024
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Clozapine-induced seizures, electroencephalography abnormalities, and clinical responses in Japanese patients with schizophrenia

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