Dopamine supersensitivity psychosis and delay of clozapine treatment in patients with treatment-resistant schizophrenia
Dopamine supersensitivity psychosis and delay of clozapine treatment in patients with treatment-resistant schizophrenia
复制标题
难治性精神分裂症患者的多巴胺超敏性精神病与氯氮平治疗延迟
DOI：
10.1097/yic.0000000000000442
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Iyo M,
中科院分区：
文献类型：
--
作者：
Masumo Y;Kanahara N;Kogure M;Yamasaki F;Nakata Y;Iyo M,
氯氮平的利用不足和患者对氯氮平的治疗耐药都是世界性的严重问题。确定预测氯氮平疗效的临床标志物将有助于临床医生更有效地利用氯氮平治疗。本研究回顾评估了47名难治性精神分裂症(TRS)患者的多巴胺超敏精神病(DSP)，以及其他指标，如发病年龄和氯氮平的延迟服用。在氯氮平开始治疗1年和2年后用CGI-C评定氯氮平的疗效。结果显示，DSP组从指定TRS到引入氯氮平的延迟时间往往更长，并且在氯氮平治疗后继续有轻微更严重的精神病理学，仅有轻微改善。Logistic回归分析表明，发病年龄是预测氯氮平疗效的唯一显著指标：起病年龄<20岁的患者对氯氮平的反应明显好于起病年龄≥为20岁的患者。目前的研究提示，DSP可能与氯氮平的引入延迟较长以及氯氮平治疗后顽固性症状的持续有关，而发病年龄较早可能与氯氮平的较好反应有关。
Both the underutilization of clozapine and treatment resistance of patients to clozapine are serious problems worldwide. Identifying clinical markers predicting response to clozapine would help clinicians more effectively utilize clozapine treatment. The present study retrospectively assessed dopamine supersensitivity psychosis (DSP) in addition to other measures such as age at disease onset and delay of clozapine introduction for a total of 47 treatment-resistant schizophrenia (TRS) patients. The response to clozapine was judged with CGI-C at 1 and 2 years from clozapine introduction. Results revealed that the DSP group tended to have a longer delay between designation of TRS and introduction of clozapine and continued to have slightly more severe psychopathology after treatment with clozapine, showing only slight improvement. The logistic regression analysis showed that the age at disease onset was the only significant indicator, predicting responsiveness to clozapine: patients with an onset age< 20 years had a significantly better response to clozapine than patients with an onset age≥ 20 years. The present study suggests that DSP might be related to a longer delay in clozapine introduction and the persistence of refractory symptoms despite clozapine treatment, whereas early age of disease onset might be related to a better response to clozapine.
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DOI：
10.1176/appi.ajp.2013.12050674
发表时间：
2013-06
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Andreasen NC;Liu D;Ziebell S;Vora A;Ho BC
通讯作者：
Ho BC
影响因子：
2.9
作者：
Kohler-Forsberg, Ole;Horsdal, Henriette T.;Gasse, Christiane
通讯作者：
Gasse, Christiane
影响因子：
4.1
作者：
Kimura, Hiroshi;Kanahara, Nobuhisa;Iyo, Masaomi
通讯作者：
Iyo, Masaomi
标准化试验中氯氮平反应的时间。
DOI：
10.1176/ajp.154.9.1243
发表时间：
1997
期刊：
The American journal of psychiatry.
影响因子：
--
作者：
Conley,RR;CarpenterJr,WT;Tamminga,CA
通讯作者：
Tamminga,CA
影响因子：
2.9
作者：
Wheeler, Amanda J.
通讯作者：
Wheeler, Amanda J.