The clozapine conundrum: Navigating neutropenia and the pursuit of effective care in treatment-resistant schizophrenia.

IF 1.1 4区 医学 Q4 PSYCHIATRY International Journal of Psychiatry in Medicine Pub Date : 2024-09-01 Epub Date: 2023-11-16 DOI:10.1177/00912174231214647
Anindya Kar, Thomas Nutting, Mohammad Ikram, Charles Sullivan
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Abstract

Background: This case explores the challenges encountered in managing treatment-resistant paranoid schizophrenia, focusing on the limitations of using clozapine due to the risk of neutropenia. The United Kingdom Clozapine Patient Monitoring Service (UK CPMS) and its eligibility criteria are discussed, highlighting the potential benefits of expanding access to clozapine for patients who could potentially benefit from this medication. The integration of clozapine genetic testing as a personalized approach is explored, emphasizing the importance of identifying patients with a favorable genetic profile for clozapine response.Methods: Case report.Results: The case presentation of Mr. X exemplifies the difficulties faced in managing treatment-resistant schizophrenia when access to clozapine is restricted, leading to persistent negative symptoms.Conclusion: The article underscores the importance of innovative solutions and personalized care to enhance the treatment outcomes for patients with treatment-resistant paranoid schizophrenia. It acknowledges that certain restrictions of clozapine use may limit the effective management of patients with this condition.

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氯氮平难题:在难治性精神分裂症中导航中性粒细胞减少症和追求有效护理。
背景:本病例探讨了在治疗难治性偏执型精神分裂症中遇到的挑战,重点是由于中性粒细胞减少的风险而使用氯氮平的局限性。讨论了英国氯氮平患者监测服务(UK CPMS)及其资格标准,强调了扩大氯氮平可及性的潜在益处,这些患者可能从这种药物中获益。整合氯氮平基因检测作为一种个性化的方法进行了探索,强调了识别具有氯氮平反应有利基因谱的患者的重要性。研究样本:X先生的病例说明了当氯氮平的使用受到限制,导致持续的阴性症状时,管理难治性精神分裂症所面临的困难。结论:本文强调了创新解决方案和个性化护理对提高难治性偏执型精神分裂症患者治疗效果的重要性。它承认,在这种情况下,某些限制可能会限制对个人的治疗效果。
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来源期刊
CiteScore
3.00
自引率
5.00%
发文量
55
审稿时长
6-12 weeks
期刊介绍: The International Journal of Psychiatry in Medicine (IJPM) bridges the gap between clinical psychiatry research and primary care clinical research. Providing a forum for addressing: The relevance of psychobiological, psychological, social, familial, religious, and cultural factors in the development and treatment of illness; the relationship of biomarkers to psychiatric symptoms and syndromes in primary care...
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