Does the Starting of Clozapine Influence Coprescription of Other Medications?: A Study From India.
Adult
Aged
Antipsychotic Agents
/ administration & dosage
Clozapine
/ administration & dosage
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
India
Male
Middle Aged
Outpatients
Practice Patterns, Physicians'
/ statistics & numerical data
Prospective Studies
Psychiatric Status Rating Scales
Psychotic Disorders
/ drug therapy
Psychotropic Drugs
/ administration & dosage
Schizophrenia
/ drug therapy
Treatment Outcome
Young Adult
Journal
Journal of clinical psychopharmacology
ISSN: 1533-712X
Titre abrégé: J Clin Psychopharmacol
Pays: United States
ID NLM: 8109496
Informations de publication
Date de publication:
Historique:
entrez:
5
3
2021
pubmed:
6
3
2021
medline:
27
10
2021
Statut:
ppublish
Résumé
Little is understood about the prescription load before and after the starting of clozapine. Accordingly, this study aimed to evaluate the medication load of patients receiving clozapine, just before starting clozapine and after being on clozapine for at least 1 year. Additionally, the impact of clozapine on severity of illness was evaluated. Two hundred seventy-seven outpatients receiving clozapine were prospectively evaluated for their prescription after at least 1 year of starting clozapine. Additionally, these patients were assessed on the Clinical Global Impression-Improvement scale to evaluate the overall clinical benefit with clozapine. They had been receiving clozapine for 6.55 (SD, 4.8; range, 1-24; median, 5) years at the time of assessment. At the start of clozapine, more than one third of the patients were receiving 2 antipsychotics. A small proportion was receiving other psychotropics, such as antidepressants, mood stabilizers, and benzodiazepines. After being on clozapine for 1 year, there was a significant reduction in the number of patients receiving two antipsychotic medications (P < 0.001), number of patients receiving antidepressants (if amitriptyline was left out), benzodiazepine (P < 0.001), and anticholinergic medications (P < 0.001). Further, there was a reduction in the mean chlorpromazine equivalent of antipsychotics (P < 0.001) and the total number of medications received by the patients (P < 0.001). However, there was an increase in the prescription rates of antihypertensive drugs (P = 0.03), anti-diabetic medications (P < 0.01), and anti-dyslipidemic medications. At follow-up, there was a significant improvement in symptoms as assessed by Clinical Global Impression-Improvement scale. This study suggests that long-term use of clozapine is associated with substantial improvement in symptoms with a reduction in the medication load.
Sections du résumé
PURPOSE/BACKGROUND
OBJECTIVE
Little is understood about the prescription load before and after the starting of clozapine. Accordingly, this study aimed to evaluate the medication load of patients receiving clozapine, just before starting clozapine and after being on clozapine for at least 1 year. Additionally, the impact of clozapine on severity of illness was evaluated.
METHODS/PROCEDURES
METHODS
Two hundred seventy-seven outpatients receiving clozapine were prospectively evaluated for their prescription after at least 1 year of starting clozapine. Additionally, these patients were assessed on the Clinical Global Impression-Improvement scale to evaluate the overall clinical benefit with clozapine.
FINDINGS/RESULTS
RESULTS
They had been receiving clozapine for 6.55 (SD, 4.8; range, 1-24; median, 5) years at the time of assessment. At the start of clozapine, more than one third of the patients were receiving 2 antipsychotics. A small proportion was receiving other psychotropics, such as antidepressants, mood stabilizers, and benzodiazepines. After being on clozapine for 1 year, there was a significant reduction in the number of patients receiving two antipsychotic medications (P < 0.001), number of patients receiving antidepressants (if amitriptyline was left out), benzodiazepine (P < 0.001), and anticholinergic medications (P < 0.001). Further, there was a reduction in the mean chlorpromazine equivalent of antipsychotics (P < 0.001) and the total number of medications received by the patients (P < 0.001). However, there was an increase in the prescription rates of antihypertensive drugs (P = 0.03), anti-diabetic medications (P < 0.01), and anti-dyslipidemic medications. At follow-up, there was a significant improvement in symptoms as assessed by Clinical Global Impression-Improvement scale.
IMPLICATIONS/CONCLUSIONS
CONCLUSIONS
This study suggests that long-term use of clozapine is associated with substantial improvement in symptoms with a reduction in the medication load.
Identifiants
pubmed: 33666401
doi: 10.1097/JCP.0000000000001348
pii: 00004714-202103000-00011
doi:
Substances chimiques
Antipsychotic Agents
0
Psychotropic Drugs
0
Clozapine
J60AR2IKIC
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
148-154Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
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