Clinical predictors of therapeutic response to clozapine in a sample of Turkish patients with treatment-resistant schizophrenia

Semiz, Ümit Başar; Çetin, Mesut; Başoğlu, Cengiz; Ebrinç, Servet; Uzun, Özcan; Herken, Hasan; Balıbey, Hakan; Algül, Ayhan; Ateş, Alpay

doi:10.1016/j.pnpbp.2007.06.002

Cited by 31 publications

(16 citation statements)

References 46 publications

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“…• The generalizability of some of the findings is limited owing to the small size of some of the groups in the sample. their treatment problematic (1,2). However, it is arguably these individuals that require the most intensive and effective management because of the enduring disability they experience (3).…”

Section: Limitationsmentioning

confidence: 99%

Reason for clozapine cessation

Pai

Vella

2011

Acta Psychiatr Scand

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Section: Limitationsmentioning

confidence: 99%

Reason for clozapine cessation

Pai

Vella

2011

Acta Psychiatr Scand

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“…Refractory or treatment‐resistant schizophrenia (SZ) afflicts approximately 30% of individuals diagnosed with a SZ spectrum disorder (1–3). For these individuals, clozapine (CLZ) has long been considered the most efficacious treatment option and its usage is reserved for this group because of its high side effect burden (1, 2, 4).…”

Section: Introductionmentioning

confidence: 99%

“…However, it must be noted that the patients in Kane et al. (4) sample were highly resistant to previous antipsychotic treatments and although some patients fail to respond adequately to CLZ; CLZ remains the ‘gold standard’ treatment for refractory SZ (1–4).…”

Section: Introductionmentioning

confidence: 99%

Augmentation of clozapine with another pharmacological agent: treatment for refractory schizophrenia in the ‘real world’

Pai

Laidlaw²,

Vella

2012

Acta Psychiatr Scand

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Pai NB, Laidlaw M, Vella S‐C. Augmentation of clozapine with another pharmacological agent: treatment for refractory schizophrenia (SZ) in the ‘real world’. Objective: Refractory schizophrenia (SZ) affects approximately 30% of people with SZ. Clozapine (CLZ) is the gold standard treatment; however, there are still patients who are non‐responsive or partially responsive to treatment. Although a lack of evidence exists in reality, these patients are treated with a combination of agents in addition to CLZ. Therefore, this article reviews the prevalence of the augmentation of CLZ with additional agents. Method: This study was cross‐sectional; physicians in a region of Australia in May 2011 were contacted to provide details of their patients on CLZ and any additional agents. The data set consists of 84 patients. Results: The majority of the patients 84.5% were taking at least one additional agent. Of those taking additional agents, they derived from the following classes’ antipsychotics (72%), antidepressants (30%), mood stabilisers (17%), antimetabolic agents (13%), benzodiazepines (7%), anticholinergics (4%) and miscellaneous agents (12.5%). Conclusion: It is apparent that CLZ is routinely augmented with other agents despite the lack of an evidence base. However, concerning was the lack of augmentation with antimetabolic agents despite the paucity of literature reporting the detrimental impact of antipsychotic treatment upon patients metabolic indices. The findings are discussed in the context of the current recommendations and empirical literature.

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“…Clozapine is now well established as the treatment of choice for severely ill schizophrenic patients who are refractory to treatment. Therefore, it is of special interest to investigate differences in clinical variables between responders and non‐responders to this drug [Semiz et al, 2007]. In recent years, there have been several studies on possible clinical predictors of responses to clozapine treatment.…”

Section: Introductionmentioning

confidence: 99%

“…In the above‐mentioned studies, male gender, age at onset, shorter duration of illness, higher levels of positive and negative symptoms, and individual genetic differences have been reported to play a role in clinical responses to medications [Cordeiro et al, 2006; Semiz et al, 2007]. It is difficult to identify which factor is predominant due to inconsistent and somewhat contradictory results caused by heterogeneity of the disorder, specific subgroups of schizophrenic patients, and the effect of racial stratification.…”

Section: Introductionmentioning

confidence: 99%

Lack of association between DRD3 gene polymorphism and response to clozapine in Turkish schizoprenia patients

Barlas

Çetin

Semiz

et al. 2008

American J of Med Genetics Pt B

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It is hypothesized that molecular components of dopaminergic system, especially the dopamine D3 receptor gene (DRD3), may play a crucial role in the pathophysiology of schizophrenia, because it is abundant in the limbic system of the brain and it binds antipsychotic drugs. Several groups attempted to find an association between a serine-to-glycine polymorphism of the DRD3 gene (Ser9Gly) and schizophrenia; however, the results were inconsistent. In this study, we aimed to investigate the relationship of the Serine/Glycine polymorphism of the DRD3 gene with therapeutic response to clozapine treatment between Turkish schizophrenia patients (N = 92) and healthy controls (N = 100). Genotype groups were comparable in BPRS, SAPS, SANS analysis of response to clozapine. Our results suggest that an association between the Ser/Gly polymorphism of DRD3 gene and response to clozapine in Turkish schizophrenia patients is unlikely to exist.

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Clinical predictors of therapeutic response to clozapine in a sample of Turkish patients with treatment-resistant schizophrenia

Cited by 31 publications

References 46 publications

Reason for clozapine cessation

Reason for clozapine cessation

Augmentation of clozapine with another pharmacological agent: treatment for refractory schizophrenia in the ‘real world’

Lack of association between DRD3 gene polymorphism and response to clozapine in Turkish schizoprenia patients

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