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Challenges in Prescribing Clozapine in the Era of COVID-19: A Review Focused on Immunological Implications

Jeong SH, Kim YS

The global COVID-19 pandemic has disrupted every aspect of the healthcare system. Apart from the issues surrounding COVID-19 itself, care for existing patients has met many challenges. One such challenge...
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Change of Prescribing Pattern after Clozapine Discontinuation: A Retrospective Chart Review

Kang SH

Objectives: Despite the high discontinuation rate of clozapine in refractory schizophrenia, there is limited evidence regarding the suggested treatment after clozapine discontinuation. Methods: The medical records of 37 patients who discontinued...
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Current Status of Clozapine for Treatment-Resistant Schizophrenia

Kim SH

Clozapine is the first and most effective atypical antipsychotic drug for treatment-resistant schizophrenia (TRS). After withdrawal of clozapine due to concerns of agranulocytosis, clozapine was reintroduced with a comprehensive safety...
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Cariprazine Add-on in Inadequate Clozapine Response: A Report on Two Cases

Berardis DD, Rapini G, Olivieri L, Giardini A, Lauretis ID, Serroni N, Orsolini L, Fornaro M, Iasevoli F, Trotta S, Cottura P, Vellante F, Alessandrini M, Giannantonio MD

Cariprazine is a novel antipsychotic drug that exerts partial agonism of dopamine D2 /D3 receptors with preferential binding to the D 3 receptor, antagonism of 5HT2B receptors, and partial agonism...
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Resolution of Persistent Auditory Verbal Hallucinations after Long-term Electroconvulsive Therapy Maintenance: A Case Report of a Patient with Clozapine-resistant Schizophrenia

Chung IW, Kim HS, Kim JH, Jang JH, Kim YS

A 32-year-old woman with schizophrenia and persistent auditory verbal hallucinations (AVHs), which caused continuous suicidal thoughts and depression, was treated with electroconvulsive therapy (ECT) of an acute course followed by...
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Clozapine Is Better Tolerated in Younger Patients: Risk Factors for Discontinuation from a Nationwide Database in Japan

Toyoda K, Hata T, Yamauchi S, Kinoshita S, Nishihara M, Uchiyama K, Inada K, Kanazawa T

Objective The effectiveness of clozapine is clearly superior to other antipsychotics in the treatment of refractory schizophrenia. Clozapine leads to various side effects, and therefore many patients are forced to...
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Clozapine in the Time of COVID-19

Boland X, Dratcu L

Clozapine is the most effective antipsychotic for treatment resistant schizophrenia but adverse reactions to clozapine include neutropenia. The current COVID-19 pandemic may raise specific concerns for clinicians prescribing clozapine for...
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A Retrospective Study on the Effect of 1-Year Clozapine Administration on Platelet Activity in Patients with Schizophrenia or Schizoaffective Disorder

Jang E, Lee JW, Kim SJ, Oh HS, Im WY, Lee NH, Kim JW

Objectives:Clozapine has been known to increase the possibility of developing cardio/cerebrovascular diseases, and the platelet activation has been deemed to be related to the occurrence of them. In author’s previous...
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Relationship of Change in Plasma Clozapine/N-desmethylclozapine Ratio with Cognitive Performance in Patients with Schizophrenia

Park R, Kim S, Kim E

Objective The clozapine/N-desmethylclozapine (NDMC) ratio is proposed to be used as a predictor of cognitive performance in clozapine-treated patients, as its principal metabolite, NDMC, has an opposite action with clozapine...
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Treatment-Resistant Schizophrenia: Terminology and Clinical Features

Lee K

Schizophrenia is one of serious mental illnesses and is often described as a heterogeneous disorder. Approximately one-third of schizophrenia cases are treatment-resistant schizophrenia (TRS). The aim of this study was...
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Long-Term Changes in Self-Report Auditory Verbal Hallucinations in Patients with Schizophrenia Using Clozapine

Chung IW, Jeong SH, Jung HY, Youn T, Kim SH, Kim YS

This study explored long-term changes in self-report auditory verbal hallucinations (AVHs) among patients with schizophrenia taking clozapine. Forty-four patients who were evaluated more than twice and were above the mild...
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Relationship between Clozapine-Induced Electroencephalogram Abnormalities and Serum Concentration of Clozapine in Japanese Patients with Treatment-Resistant Schizophrenia

Kikuchi YS, Kanbayashi T, Shimizu T

OBJECTIVE: The objective of this study was to investigate the relationship between the serum concentration of clozapine (C-CLZ), N-desmethylclozapine (N-CLZ) and the daily dose of CLZ (D-CLZ), and the relationships...
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Prescribing Pattern of Clozapine and Clinical Factors associated with Discontinuation of Clozapine

Kang SH, Lee HW

OBJECTIVES: Clozapine is the drug of choice in treatment-resistant schizophrenia. However, its use is often delayed and a significant proportion of clozapine treated patients fails to respond and experience potentially...
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A Case of Clozapine-induced Corneal and Lenticular Pigmentation

An JS, Lee YM, Kwag JY, Hyun J, Choi JS, Pak KH, Chung SK

PURPOSE: To report a case of corneal and lenticular pigmentation after prolonged clozapine therapy. CASE SUMMARY: A 56-year-old male visited our hospital with a progressive decline in vision that affected both...
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Clozapine in the Treatment of Aggression in Conduct Disorder in Children and Adolescents: A Randomized, Double-blind, Controlled Trial

Juárez-Treviño M, Esquivel A, Isida LM, Delgado DA, de la O Cavazos ME, Ocañas LG, Sepúlveda RS

OBJECTIVE: This study was conducted to compare the efficacy of clozapine vs. risperidone in the treatment of aggression in conduct disorder in children and adolescents. METHODS: Twenty-four children with conduct disorder...
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Efficacy of Asenapine in Schizophrenia Resistant to Clozapine Combined with Electroconvulsive Therapy: A Case Report

Ochi S, Inoue S, Yoshino Y, Shimizu H, Iga JI, Ueno SI

Schizophrenic patients resistant to antipsychotics are diagnosed as having treatment-refractory schizophrenia, and they are treated with clozapine. However, clozapine is sometimes combined with electroconvulsive therapy (ECT) if clozapine monotherapy fails....
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Influence of clozapine on neurodevelopmental protein expression and behavioral patterns in animal model of psychiatric disorder induced by low-level of lead

Lee H, Lee M, Kim HK, Kim YO, Kwon JT, Kim HJ

Exposure to lead during pregnancy is a risk factor for the development of psychiatric disorders in the offspring. In this study, we investigated whether exposure to low levels of lead...
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Comparison of Inflammatory Markers Including C-Reactive Protein between Treatment Resistant Schizophrenia and Non-Treatment Resistant Schizophrenia

Lee H, Jung M, Hong N, Jon DI

OBJECTIVES: The present study is to investigate inflammatory markers and associated clinical factors between treatment resistant schizophrenia and non-treatment resistant schizophrenia. METHODS: Of the 116 schizophrenia subjects who were hospitalized for...
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Combination of In Vivo [¹²³I]FP-CIT SPECT and Microdialysis Reveals an Antipsychotic Drug Haloperidol-induced Synaptic Dopamine Availability in the Rat Midbrain and Striatum

Park SH, Song YS, Moon BS, Lee BC, Park HS, Kim SE

Synaptic dopamine (DA) is mainly regulated by the presynaptic DA transporter (DAT). Single-photon emission computerized tomography (SPECT) with the DAT radiotracer [¹²³I]FP-CIT assesses changes in synaptic DA availability when endogenous...
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Successful Management of Clozapine-induced Akathisia with Gabapentin Enacarbil: A Case Report

Takeshima , Ishikawa H, Kikuchi Y, Kanbayashi T, Shimizu T

The management of clozapine (CLZ)-induced adverse events affects patient prognoses. Akathisia is a relatively rare adverse event related to CLZ administration and thus the management of this syndrome is not...
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