دورية أكاديمية
Clozapine for Treatment-Refractory Aggressive Behavior.
| العنوان: | Clozapine for Treatment-Refractory Aggressive Behavior. |
|---|---|
| المؤلفون: | Andreea T; 1st and 3rd Clinical Departments, Clinical Hospital of Psychiatry and Neurology of Brasov, Brasov, Romania., Petru I; 1st and 3rd Clinical Departments, Clinical Hospital of Psychiatry and Neurology of Brasov, Brasov, Romania. petru_ifteni@yahoo.com., Miron AA; 1st and 3rd Clinical Departments, Clinical Hospital of Psychiatry and Neurology of Brasov, Brasov, Romania., Paula-Simina P; 1st and 3rd Clinical Departments, Clinical Hospital of Psychiatry and Neurology of Brasov, Brasov, Romania., Lorena D; Faculty of Medicine, Transilvania University of Brasov, 56 Nicolae Bălcescu Str., 500019, Brasov, Romania. |
| المصدر: | The Psychiatric quarterly [Psychiatr Q] 2021 Jun; Vol. 92 (2), pp. 721-733. Date of Electronic Publication: 2020 Sep 12. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Kluwer Academic/Plenum Publishers Country of Publication: United States NLM ID: 0376465 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-6709 (Electronic) Linking ISSN: 00332720 NLM ISO Abbreviation: Psychiatr Q Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 1999- : New York, NY : Kluwer Academic/Plenum Publishers Original Publication: Utica, N. Y. |
| مواضيع طبية MeSH: | Aggression/*drug effects , Aggression/*psychology , Clozapine/*pharmacology , Clozapine/*therapeutic use, Adult ; Aged ; Bipolar Disorder/drug therapy ; Bipolar Disorder/psychology ; Cognition/drug effects ; Cognition Disorders/drug therapy ; Cognition Disorders/psychology ; Female ; Humans ; Intellectual Disability/drug therapy ; Intellectual Disability/psychology ; Male ; Personality Disorders/drug therapy ; Personality Disorders/psychology ; Psychotic Disorders/drug therapy ; Psychotic Disorders/psychology ; Retrospective Studies |
| مستخلص: | Emergency psychiatry has the main role of resolving suicidal behavior and aggression. These severe psychiatric symptoms can be found in many psychiatric disorders such as schizophrenia, bipolar disorder, major depression, personality disorders, cognitive disorders, intellectual disability and substance abuse. Although indications for the use of antipsychotics are limited to a specific group of diseases, they are frequently used as rescue medication in high-risk or nonresponsive cases. Clozapine, the gold standard for TRS (treatment resistant schizophrenia) is effective in controlling aggression. The aim of the research was to identify the use of clozapine for treatment-refractory aggressive behavior in psychiatric emergency. A retrospective study based on the paper files of patients admitted between 2010 and 2019 in the Clinical Hospital of Psychiatry and Neurology of Brasov, Romania. Were included all the patients admitted as a psychiatric emergency and treated with clozapine for aggressive behavior. The hospital is an academic institution with 150 beds for acute patients, serving an area of over 600,000 inhabitants. It is the main public institution where patients with psychiatric emergencies are hospitalized. Off 19,000 patients admitted during the study period, 504 patients (2,4%) with a diagnosis other than schizophrenia or schizoaffective disorder received clozapine for aggressiveness (89.5%). The first four diagnoses identified were bipolar disorder (n = 172), intellectual disability (n = 128), cognitive impairment (n = 112), and personality disorder (n = 92). Other disorders identified but with a smaller number of cases were major depressive disorder (n = 3), adjustment disorders (n = 2), delusional disorder (n = 2), obsessive compulsive disorder (n = 2) and postpartum psychosis (n = 1). Clozapine was used as 3rd or 4th choice. The dose was greater for manic patients (350.29 ± 98.01 mg/day) compared with all the other diagnoses. Clozapine was effective and safe in cases of patients with treatment-refractory aggressive behavior. |
| References: | Fazel S, Gulati G, Linsell L, Geddes JR, Grann M. Schizophrenia and violence: systematic review and meta-analysis. PLoS Med. 2009;6(8):e1000120. https://doi.org/10.1371/journal.pmed.100012013 . (PMID: 196683622718581) Fazel S, Lichtenstein P, Grann M, Goodwin GM, Långström N. Bipolar disorder and violent crime: new evidence from population-based longitudinal studies and systematic review. Arch GenPsychiatry. 2010;67(9):931–8. Ferns T, Cork A. Managing alcohol related aggression in the emergency department (part I). Int Emerg Nurs. 2008;16(1):43–7. https://doi.org/10.1016/j.ienj.2007.12.001 . (PMID: 18519053) Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, Goodwin FK. Comorbidity of mental disorders with alcohol and other drug abuse. Results from the epidemiologic catchment area (ECA) study. JAMA. 1990;264:2511–8. (PMID: 2232018) Meltzer H, Kostakoglu A. Treatment resistant schizophrenia. In: Liberman J, Murray R, editors. Comprehensive Care of Schizophrenia: a textbook of clinical management. London: Martin Dunitz; 2001. p. 181–203. Guy W. Clinical Global Impression: ECDEU Assessment Manual for Psychopharmacology. Rev. ed. Rockville: National Institutes of Mental Health; 1976. p. 218–22. Ifteni P, Szalontay AS, Teodorescu A. Reducing restraint with clozapine in involuntarily admitted patients with schizophrenia. Am J Ther. 2017;24(2):e222–6. (PMID: 27984264) Calabrese JR, Kimmel SE, Woyshville MJ, Rapport DJ, Faust CJ, Thompson PA, Meltzer HY. Clozapine for treatment-refractory mania. Am J Psychiatry. 1996;153(6):759–64. https://doi.org/10.1176/ajp.153.6.759 . (PMID: 8633686) Barbini B, Scherillo P, Benedetti F, Crespi G, Colombo C, Smeraldi E. Response to clozapine in acute mania is more rapid than that of chlorpromazine. Int Clin Psychopharmacol. 1997;12(2):109–12. https://doi.org/10.1097/00004850-199703000-00006 . (PMID: 9219046) Baldessarini RJ, Pompili M, Tondo L. Suicide in bipolar disorder: Risks and management. CNS Spectr. 2006;11:465–71. (PMID: 16816785) Ifteni P, Teodorescu A, Moga MA, Pascu AM, Miclaus RS. Switching bipolar disorder patients treated with clozapine to another antipsychotic medication: a mirror image study. Neuropsychiatr Dis Treat. 2017;13:201–4. (PMID: 281821535279839) Ifteni P, Correll CU, Nielsen J, Burtea V, Kane JM, Manu P. Rapid clozapine titration in treatment-refractory bipolar disorder. J Affect Disord. 2014;166:168–72. (PMID: 25012427) Aksoy Poyraz C, Turan Ş, Demirel ÖF, Usta Sağlam NG, Yıldız N, Duran A. Effectiveness of ultra-rapid dose titration of clozapine for treatment-resistant bipolar mania: case series. Ther Adv Psychopharmacol. 2015;5(4):237–42. (PMID: 263010804535045) Nielsen J, Kane JM, Correll CU. Real-world effectiveness of clozapine in patients with bipolar disorder: results from a 2-year mirror-image study. Bipolar Disord. 2012 Dec;14(8):863–9. (PMID: 23107278) Wilkowska A, Wiglusz MS, Cubała WJ. Clozapine: promising treatment for suicidality in bipolar disorder. Psychiatr Danub. 2019;31(Suppl 3):574–8. (PMID: 31488793) Schaffer A, Isometsä ET, Tondo L, Moreno D, Turecki G, Reis C, et al. International society for bipolar disorders task force on suicide: meta-analyses and meta-regression of correlates of suicide attempts and suicide deaths in bipolar disorder. Bipolar Disord. 2015;17:1–16. https://doi.org/10.1111/bdi.12271 . (PMID: 25329791) Li X-B, Tang Y-L, Wang C-Y, de Leon J. Clozapine for treatment resistant bipolar disorder: a systematic review. Bipolar Disord. 2015;17:235–47. https://doi.org/10.1111/bdi.12272 . (PMID: 25346322) Pompili M, Baldessarini RJ, Forte A, Erbuto D, Serafini G, Fiorillo A, Amore M, Girardi P. Do atypical antipsychotics have antisuicidal effects? A hypothesis-generating overview. Int J Mol Sci. 2016;17(10):1700. https://doi.org/10.3390/ijms17101700 . (PMID: 5085732) Hammock R, Levine WR, Schroeder SR. Brief report: effects of clozapine on self-injurious behavior of two risperidone nonresponders with mental retardation. J Autism Dev Disord. 2001;31(1):109–13. (PMID: 11439749) Cohen SA, Underwood MT. The use of clozapine in a mentally retarded and aggressive population. J Clin Psychiatry. 1994;55(10):440–4. (PMID: 7961521) Gareri P, De Fazio P, Russo E, Marigliano N, De Fazio S, De Sarro G. The safety of clozapine in the elderly. Expert Opin Drug Saf. 2008;7(5):525–38. https://doi.org/10.1517/14740338.7.5.525 . (PMID: 18759705) Teodorescu A, Dima L, Ifteni P, Rogozea LM. Clozapine for treatment-refractory behavioral disturbance in dementia. Am J Ther. 2018;25(3):e320–5. (PMID: 29401113) Daniel DG. Antipsychotic treatment of psychosis and agitation in the elderly. J Clin Psychiatry. 2000;61(suppl 14):49–52. (PMID: 11154017) Argent SE, Hill SA. The novel use of clozapine in an adolescent with borderline personality disorder. Ther Adv Psychopharmacol. 2014;4(4):149–55. (PMID: 250832744104708) Zarzar T, McEvoy J. Clozapine for self-injurious behavior in individuals with borderline personality disorder. Ther Adv Psychopharmacol. 2013;3(5):272–4. (PMID: 241677023805385) Rutledge E, O'Regan M, Mohan D. Borderline personality disorder and clozapine. Ir J Psychol Med. 2007;24(1):40–1. (PMID: 30290503) Chengappa KN, Ebeling T, Kang JS, Levine J, Parepally H. Clozapine reduces severe self-mutilation and aggression in psychotic patients with borderline personality disorder. J Clin Psychiatry. 1999;60(7):477–84. (PMID: 10453803) Steinert T, Schmidt-Michel PO, Kaschka WP. Considerable improvement in a case of obsessive-compulsive disorder in an emotionally unstable personality disorder, borderline type under treatment with clozapine. Pharmacopsychiatry. 1996;29(3):111–4. (PMID: 8738316) Amamou B, Salah WB, Mhalla A, Benzarti N, Elloumi H, Zaafrane F, Gaha L. Use of clozapine for borderline personality disorder: a case report. Clin Psychopharmacol Neurosci. 2016;14(2):226–8. (PMID: 271214374857858) Brown D, Larkin F, Sengupta S, Romero-Ureclay JL, Ross CC, Gupta N, Vinestock M, Das M. Clozapine: an effective treatment for seriously violent and psychopathic men with antisocial personality disorder in a UK high-security hospital. CNS Spectr. 2014;19(5):391–402. (PMID: 246981034255317) Frankenburg FR, Zanarini MC. Clozapine treatment of borderline patients: a preliminary study. Compr Psychiatry. 1993;34(6):402–5. (PMID: 8131384) Frogley C, Anagnostakis K, Mitchell S, Mason F, Taylor D, Dickens G, Picchioni MM. A case series of clozapine for borderline personality disorder. Ann Clin Psychiatry. 2013;25(2):125–34. (PMID: 23638443) Parker GF. Clozapine and borderline personality disorder. Psychiatr Serv. 2002;53(3):348–9. (PMID: 11875239) Chengappa KNR, Baker RW, Sirri C. The successful use of clozapine in ameliorating severe self mutilation in a patient with borderline personality disorder. J Personal Disord. 1995;9(1):76–82. Rutledge E, O’Regan M, Mohan D. Borderline personality disorder and clozapine. Ir J Psychol Med. 2007;24(1):40–1. (PMID: 30290503) Vohra AK. Treatment of severe borderline personality disorder with clozapine. Indian J Psychiatry. 2010;52(3):267–9. (PMID: 211804152990830) |
| فهرسة مساهمة: | Keywords: Aggressiveness; Clozapine; Emergency psychiatry; Treatment-refractory |
| المشرفين على المادة: | J60AR2IKIC (Clozapine) |
| تواريخ الأحداث: | Date Created: 20200912 Date Completed: 20211108 Latest Revision: 20211108 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1007/s11126-020-09839-x |
| PMID: | 32918660 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1573-6709 |
|---|---|
| DOI: | 10.1007/s11126-020-09839-x |