Longitudinal changes in clozapine dose in patients with treatment-resistant schizophrenia: a 5-year retrospective cohort study
Longitudinal changes in clozapine dose in patients with treatment-resistant schizophrenia: a 5-year retrospective cohort study
复制标题
难治性精神分裂症患者氯氮平剂量的纵向变化：一项 5 年回顾性队列研究
DOI：
10.1097/yic.0000000000000429
复制
发表时间：
2023
影响因子：
2.6
通讯作者：
Takeuchi H
中科院分区：
文献类型：
--
作者：
Tsukahara M;So R;Nakajima S;Kitagawa K;Kodama M;Takeuchi H
这项回顾性队列研究旨在调查难治性精神分裂症(TRS)患者5年内氯氮平剂量的纵向变化。纳入2012年4月至2016年12月期间在医院接受氯氮平治疗并继续使用氯氮平至少1年的TRS患者。在剂量固定点比较氯氮平的剂量，定义为相同的氯氮平方案持续8周或更长时间，以及剂量固定后阶段，在氯氮平开始治疗后12、36和60个月。我们纳入了103名患者，发现氯氮平在剂量固定点和剂量固定后阶段的剂量没有显著差异。大约一半的患者在氯氮平治疗12个月后被归类为不变组，而大约40%的患者在60个月时被归类为减少组或增加组。多变量回归分析显示，从剂量固定点到氯氮平启动后60个月的氯氮平剂量变化与剂量固定点的剂量呈负相关。平均而言，在TRS患者的长期治疗期间，氯氮平的剂量没有变化，尽管大约40%的患者减少或增加了剂量。
This retrospective cohort study aimed to investigate the longitudinal changes in clozapine dose over a 5-year period in patients with treatment-resistant schizophrenia (TRS). Patients with TRS who were administered clozapine at a hospital between April 2012 and December 2016 and continued treatment with clozapine for at least 1 year were included. Clozapine doses were compared at the dose-fixation point, defined as when the same regimen of clozapine had been continued for 8 weeks or longer, and the post-dose-fixation phase, at 12, 36 and 60 months after clozapine initiation. We included 103 patients and found no significant differences in clozapine dose between the dose-fixation point and post-dose-fixation phase. Approximately half of the patients were categorized into an unchanged group at 12 months after clozapine initiation, whereas approximately 40% of patients were categorized into either the decreased or increased group at 60 months. Multivariable regression analysis revealed that the change in clozapine dose between the dose-fixation point and 60 months after clozapine initiation was negatively associated with clozapine dose at the dose-fixation point. On average, the clozapine dose was unchanged during long-term treatment in patients with TRS, although the dose was decreased or increased in approximately 40% of the patients.