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KMID : 1177320160190010017
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Korean Journal of Schizophrenia Research
2016 Volume.19 No. 1 p.17 ~ p.24
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Reason for Clozapine Discontinuation
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Cho Jin-Woo
Kim Won-Hyung
Shin Jun-Hwan
Kim Ji-Hyun
Lee Jung-Sub
Bae Jae-Nam
Kim Chul-Eung
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Abstract
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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.
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KEYWORD
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Schizophrenia, Clozapine, Antipsychotics, Treatment discontinuation, Side-Effect
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