Do Asians Patients Require Only Half of the Clozapine Dose Prescribed for Caucasians? A Critical Review

Jann, Michael W.

doi:10.4103/ijpsym.ijpsym_495_19

Cited by 5 publications

(4 citation statements)

References 20 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous similar studies have shown females are more affected than males. 18 The reason for no such difference may be that all the subpopulation were facing similar situations and on the verge of coping with various psychiatric morbidities. The interventions for the psychological problem due to COVID-19 needs to be prioritized.…”

Section: Discussionmentioning

confidence: 99%

Weathering the Storm: Psychological Impact of COVID-19 Pandemic on Clinical and Nonclinical Healthcare Workers in India

Ravindranath

Bhatt

Bhumika

et al. 2021

Indian Journal of Critical Care Medicine

View full text Add to dashboard Cite

A bstract Background Coronavirus disease-2019 (COVID-19) pandemic has exposed healthcare workers (HCWs) to a unique set of challenges and stressors. Our frontline workers are under tremendous psychological pressure because of the ever-rising crisis. This study was done to assess the magnitude of the psychological impact of the COVID-19 pandemic on clinical and nonclinical HCWs in India. Materials and methods It was a cross-sectional, online survey that was done from June 1, 2020, to July 4, 2020. A total of 313 clinical and nonclinical HCWs, who were directly or indirectly involved in patient care, participated in the study. The psychological impact was assessed in terms of four variables: insomnia, anxiety, depression, and stress. Insomnia was assessed by the Insomnia Severity Index (ISI). Anxiety and depression were assessed via the Patient Health Questionnaire-4 (PHQ-4), which included a 2-item anxiety scale and a 2-item depression scale (PHQ-2). Stress was assessed via the Perceived Stress Scale (PSS). We also compared the psychological impact of this pandemic between clinical and nonclinical HCWs. Results 7.3% of HCWs were having moderate insomnia, 3.8% had severe insomnia, and 20.8% were having subthreshold insomnia. Severe anxiety and depression were found in 6.7% of respondents. 8.0 and 32.3% of the respondents had moderate and mild anxiety–depression, respectively. 6.4% had high perceived stress. 47.6 and 46.0% of the respondents had moderate and low stress, respectively. There was a statistically significant difference in severe insomnia between clinical and nonclinical HCWs, whereas no significant difference in anxiety, depression, and stress between clinical and nonclinical HCWs. Conclusion This study suggests that psychological morbidity is prevalent among both clinical and nonclinical HCWs and both males and females. Early intervention may be beneficial to prevent this issue. How to cite this article Sunil R, Bhatt MT, Bhumika TV, Thomas N, Puranik A, Chaudhuri S, et al. Weathering the Storm: Psychological Impact of COVID-19 Pandemic on Clinical and Nonclinical Healthcare Workers in India. Indian J Crit Care Med 2021;25(1):16–20.

show abstract

Section: Discussionmentioning

confidence: 99%

Weathering the Storm: Psychological Impact of COVID-19 Pandemic on Clinical and Nonclinical Healthcare Workers in India

Ravindranath

Bhatt

Bhumika

et al. 2021

Indian Journal of Critical Care Medicine

View full text Add to dashboard Cite

show abstract

“…In times of social distancing measures to curb COVID-19, Gelder et al 14 recommend internet-based help platforms, replacing conventional in-person support to DV survivors, with a safety mechanism to quickly exit the page and clear browsing history as the abusers may monitor phone and internet use. Vranda and Febna 15 outlined the prerequisite for offering consultation using tele-health services to ensure women’s safety. Evans et al 16 suggest safety measures such as establishing signals such as raised fist on a video call or setting phrases during an audio call to identify the presence of an abusive partner during teleconsultation.…”

Section: Discussionmentioning

confidence: 99%

“…She was also advised to delete the incoming and outgoing callers’ list immediately after the session, to prevent tracking or monitoring of calls. The immediate risk of violence was assessed using a danger assessment scale 13 to ensure the safety of the client and her children. The result revealed a moderate level of risk of danger from the husband.…”

Section: Process Of Tele-case Work Consultationmentioning

confidence: 99%

Tele-Case Work Consultation to Woman Survivor of Domestic Violence During COVID 19 Pandemic

Vranda

2021

Indian Journal of Psychological Medicine

View full text Add to dashboard Cite

The COVID-19 pandemic and subsequent lockdown to mitigate the spread of the COVID-19 have resulted in social isolation, reduced social support system, and increased domestic violence (DV) cases against women and children. The governments and NGOs have taken several measures to prevent DV by starting helpline, WhatsApp numbers, and counseling services during the lockdown to safeguard the women. This paper describes a case scenario of how we offered tele-case work consultation during the lockdown period due to the COVID-19 pandemic, the procedure adopted, and preventive measures followed while providing a tailor-made psychosocial intervention to a DV survivor. It also discusses the strengths and challenges while offering tele-consultation and possible steps to overcome the technological barriers to mental health professionals.

show abstract

“…In rare cases, rapid metabolism of clozapine due to yet unknown causes may preclude reaching sufficient plasma clozapine levels. 133 – 135 Here, augmentation with low doses of fluvoxamine, a strong CYP1A2 inhibitor, should be considered. 136 – 138 A total of 25–50 mg of fluvoxamine can raise plasma clozapine levels five- to ten-fold within 2–4 weeks 139 – 141 and also triple clozapine’s half-life.…”

Section: Pharmacokinetics and Interactionsmentioning

confidence: 99%

Second to none: rationale, timing, and clinical management of clozapine use in schizophrenia

Qubad

Bittner

2023

Therapeutic Advances in Psychopharmacology

View full text Add to dashboard Cite

Despite its enduring relevance as the single most effective and important evidence-based treatment for schizophrenia, underutilization of clozapine remains considerable. To a substantial degree, this is attributable to a reluctance of psychiatrists to offer clozapine due to its relatively large side-effect burden and the complexity of its use. This underscores the necessity for continued education regarding both the vital nature and the intricacies of clozapine treatment. This narrative review summarizes all clinically relevant areas of evidence, which support clozapine’s wide-ranging superior efficacy – for treatment-resistant schizophrenia (TRS) and beyond – and make its safe use eminently feasible. Converging evidence indicates that TRS constitutes a distinct albeit heterogeneous subgroup of schizophrenias primarily responsive to clozapine. Most importantly, the predominantly early onset of treatment resistance and the considerable decline in response rates associated with its delayed initiation make clozapine an essential treatment option throughout the course of illness, beginning with the first psychotic episode. To maximize patients’ benefits, systematic early recognition efforts based on stringent use of TRS criteria, a timely offer of clozapine, thorough side-effect screening and management as well as consistent use of therapeutic drug monitoring and established augmentation strategies for suboptimal responders are crucial. To minimize permanent all-cause discontinuation, re-challenges after neutropenia or myocarditis should be considered. Owing to clozapine’s unique efficacy, comorbid conditions including substance use and most somatic disorders should not dissuade but rather encourage clinicians to consider clozapine. Moreover, treatment decisions need to be informed by the late onset of clozapine’s full effects, which for reduced suicidality and mortality rates may not even be readily apparent. Overall, the singular extent of its efficacy combined with the high level of patient satisfaction continues to distinguish clozapine from all other available antipsychotics.

show abstract

Do Asians Patients Require Only Half of the Clozapine Dose Prescribed for Caucasians? A Critical Review

Cited by 5 publications

References 20 publications

Weathering the Storm: Psychological Impact of COVID-19 Pandemic on Clinical and Nonclinical Healthcare Workers in India

Weathering the Storm: Psychological Impact of COVID-19 Pandemic on Clinical and Nonclinical Healthcare Workers in India

Tele-Case Work Consultation to Woman Survivor of Domestic Violence During COVID 19 Pandemic

Second to none: rationale, timing, and clinical management of clozapine use in schizophrenia

Contact Info

Product

Resources

About