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Concurrence of clozapine-induced diabetic ketoacidosis and neuroleptic malignant syndrome: A case report.
Medicine (Baltimore)
August 2025
Department of Medicine, Division of Endocrinology and Metabolism, Wonkwang University School of Medicine, Iksan, Republic of Korea.
Rationale: Clozapine is a unique antipsychotic drug used to treat treatment-resistant psychosis. Clozapine can induce metabolic complications and weight gain, and may lead to acute diabetic complications such as diabetic ketoacidosis (DKA). Neurological side effects of clozapine are relatively rare compared with those of typical antipsychotics; however, several cases have been reported.
View Article and Find Full Text PDFLate-Onset Neutropenia in Clozapine Users: Unrelated or Drug-Induced? A Case-Registry Analysis of Incidence, Characteristics, and Rechallenge Attempts.
Schizophr Bull
August 2025
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, United Kingdom.
Background And Hypothesis: Clozapine treatment carries a risk of blood dyscrasias (BD) and requires indefinite monitoring in many jurisdictions, a major factor in its under-utilization. Although previous studies suggest BD risk is highest early in treatment, BD events have also been reported after many years. This study compares early vs late (>6 months) suspected blood dyscrasias (SBD) and examines rechallenge outcomes as a marker for clozapine-related causation.
View Article and Find Full Text PDFClozapine Dose Reduction in Remitted Patients With Treatment-Resistant Schizophrenia: A Case Series.
Schizophr Bull
August 2025
Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), 1051 Queen Street West, Toronto, Ontario M6J 1H3, Canada.
Background: There is limited evidence on the outcomes of clozapine deprescribing in remitted treatment-resistant schizophrenia (TRS) patients. We present a series of TRS patients in remission who underwent progressive reductions in their maintenance clozapine dose.
Study Design: This was a retrospective chart review of patients treated with clozapine from March 20, 2014 to March 20, 2024, at the Centre for Addiction and Mental Health, Toronto, Canada.
Reevaluating Clozapine-Induced QT Prolongation.
Schizophr Bull
August 2025
School of Medicine, University of Queensland, Brisbane 4006, Australia.
Background And Hypothesis: Clozapine is the most effective medicine for treatment-resistant schizophrenia, but is limited by adverse events, including potential QT prolongation which can lead to life-threatening arrhythmias. Studies linking clozapine and corrected QT (QTc) prolongation may overestimate this risk due to high rates of clozapine-associated tachycardia. We investigated whether trough clozapine plasma levels are independently associated with QT prolongation after accounting for heart rate.
View Article and Find Full Text PDFMetabolic Problems Among People With Treatment-Resistant Schizophrenia are Not Unique to Clozapine.
J Clin Psychopharmacol
August 2025
North Metropolitan Health Service, Graylands Hospital, Perth, Australia.
Background: It is unclear whether treatment with clozapine, when compared directly with other antipsychotics, is differentially associated with metabolic problems among people with treatment-resistant schizophrenia (TRS). We evaluated the prevalence of diabetes, dyslipidemia, obesity, and hypertension, and parameters such as glucose, lipids, weight, and blood pressure of people with TRS managed on clozapine and non-clozapine antipsychotics.
Methods: Demographic, clinical, and metabolic data of patients with TRS who commenced clozapine between 2006 and 2016 at a public hospital were collected in 2023.