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Korean J Schizophr Res > Volume 19(1); 2016 > Article
Korean Journal of Schizophrenia Research 2016;19(1):17-24.
DOI: https://doi.org/10.16946/kjsr.2016.19.1.17    Published online April 30, 2016.
Reason for Clozapine Discontinuation.
Jin Woo Cho, Won Hyoung Kim, Jun Hwan Shin, Ji Hyun Kim, Jeong Seop Lee, Jae Nam Bae, Chul Eung Kim
Department of Psychiatry, Inha University Hospital, Incheon, Korea. kce320@inha.ac.kr
Abstract
OBJECTIVES
Approximately 30% of individuals diagnosed with schizophrenia suffer from treatment-resistant schizophrenia. Clozapine is underutilized in the management of treatment-resistant schizophrenia. To understand contributing factors, we analyzed the time course and causes of clozapine discontinuations that occurred over a 20-year period in a clinical setting.
METHODS
The reasons for discontinuation and duration of clozapine treatment from a retrospective database of 138 patients with schizophrenia who had prescribed clozapine at least a month were reviewed, with the motives for discontinuation coded. The causes for termination were analyzed.
RESULTS
Over two-thirds of the patient had ceased clozapine. The two most common causes for discontinuation were side-effects (50%), and own decision (30%). Somnolence accounted for 34% of all side-effects induced discontinuations. Hematological problems accounted for 23% of side-effect. The Maximal treatment dose of clozapine was higher in continuation group (442.36 mg) than in discontinuation group (397.26 mg). The CGI-S score when prescribing clozapine last was higher in discontinuation group than in continuous group. The patients who took atypical antipsychotics before clozapine tended to cease clozapine because of side-effects than who took typical agent.
CONCLUSION
Future studies should seek various methods to relieve side-effects of clozapine. Prospective researches using more objective tools are needed to clarify the reason for clozapine discontinuation.
Key Words: Schizophrenia · Clozapine · Antipsychotics · Treatment discontinuation · Side-Effect
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