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    클로자핀의 지연된 사용이 치료저항성 조현병 환자의 급성기 약물 반응에 미치는 영향 = Effect of Delayed Clozapine Initiation on Acute Treatment Response in Treatment-Resistant Schizophrenia

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    https://www.riss.kr/link?id=A107882820

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    다국어 초록 (Multilingual Abstract) kakao i 다국어 번역

    Objectives: Recent studies have reported that delayed initiation of clozapine can affect clinical response in patients with treatment- resistant schizophrenia (TRS). This study aimed to explore the relationship between delayed initiation of clozapine and acute treatment response.
    Methods: Sixty-five inpatients with TRS who started clozapine for the first time were included through a retrospective chart review.
    Acute treatment response was defined as a 30% reduction in the Positive and Negative Syndrome Scale score or a Clinical Global Impression of Improvement score of 1 (very much improved) or 2 (much improved) at 4 weeks after initiating clozapine.
    Results: After meeting the TRS criteria, the mean delay for initiating clozapine was approximately 13.8 months. The delay was shorter in patients who showed a better response to clozapine in logistic regression analysis (p=0.037).
    Conclusion: Our findings suggest that reducing the delay in initiating clozapine increases the effectiveness of clozapine in patients with TRS.
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    Objectives: Recent studies have reported that delayed initiation of clozapine can affect clinical response in patients with treatment- resistant schizophrenia (TRS). This study aimed to explore the relationship between delayed initiation of clozapine ...

    Objectives: Recent studies have reported that delayed initiation of clozapine can affect clinical response in patients with treatment- resistant schizophrenia (TRS). This study aimed to explore the relationship between delayed initiation of clozapine and acute treatment response.
    Methods: Sixty-five inpatients with TRS who started clozapine for the first time were included through a retrospective chart review.
    Acute treatment response was defined as a 30% reduction in the Positive and Negative Syndrome Scale score or a Clinical Global Impression of Improvement score of 1 (very much improved) or 2 (much improved) at 4 weeks after initiating clozapine.
    Results: After meeting the TRS criteria, the mean delay for initiating clozapine was approximately 13.8 months. The delay was shorter in patients who showed a better response to clozapine in logistic regression analysis (p=0.037).
    Conclusion: Our findings suggest that reducing the delay in initiating clozapine increases the effectiveness of clozapine in patients with TRS.

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    참고문헌 (Reference)

    1 강시현, "클로자핀 처방 패턴 및 클로자핀 중단과 관련된 임상 요인" 대한조현병학회 22 (22): 2-7, 2019

    2 조진우, "클로자핀 중단의 이유" 대한조현병학회 19 (19): 17-24, 2016

    3 김세현, "치료저항성 조현병에서 클로자핀 치료의 현황" 대한조현병학회 24 (24): 1-7, 2021

    4 이건석, "치료저항성 조현병: 정의와 임상양상" 대한조현병학회 23 (23): 45-50, 2020

    5 전윤희, "조현병 환자의 재원일수 결정요인 : 건강보험 입원환자데이터셋 자료를 이용하여" 한국디지털정책학회 18 (18): 257-263, 2020

    6 Hasan A, "World Federation of Societies of Biological Psychiatry (WFSBP)Guidelines for Biological Treatment of Schizophrenia, part 1: update 2012 on the acute treatment of schizophrenia and the management of treatment resistance" 13 : 318-378, 2012

    7 Howes OD, "Treatment-resistant schizophrenia:treatment response and resistance in psychosis (TRRIP) working group consensus guidelines on diagnosis and terminology" 174 : 216-229, 2017

    8 Lally J, "Treatment resistant schizophrenia-review and a call to action" 36 : 279-291, 2019

    9 Rebecca Schennach, "Treatment Response in First-episode Schizophrenia" 대한정신약물학회 10 (10): 78-87, 2012

    10 Conley RR, "Time to clozapine response in a standardized trial" 154 : 1243-1247, 1997

    1 강시현, "클로자핀 처방 패턴 및 클로자핀 중단과 관련된 임상 요인" 대한조현병학회 22 (22): 2-7, 2019

    2 조진우, "클로자핀 중단의 이유" 대한조현병학회 19 (19): 17-24, 2016

    3 김세현, "치료저항성 조현병에서 클로자핀 치료의 현황" 대한조현병학회 24 (24): 1-7, 2021

    4 이건석, "치료저항성 조현병: 정의와 임상양상" 대한조현병학회 23 (23): 45-50, 2020

    5 전윤희, "조현병 환자의 재원일수 결정요인 : 건강보험 입원환자데이터셋 자료를 이용하여" 한국디지털정책학회 18 (18): 257-263, 2020

    6 Hasan A, "World Federation of Societies of Biological Psychiatry (WFSBP)Guidelines for Biological Treatment of Schizophrenia, part 1: update 2012 on the acute treatment of schizophrenia and the management of treatment resistance" 13 : 318-378, 2012

    7 Howes OD, "Treatment-resistant schizophrenia:treatment response and resistance in psychosis (TRRIP) working group consensus guidelines on diagnosis and terminology" 174 : 216-229, 2017

    8 Lally J, "Treatment resistant schizophrenia-review and a call to action" 36 : 279-291, 2019

    9 Rebecca Schennach, "Treatment Response in First-episode Schizophrenia" 대한정신약물학회 10 (10): 78-87, 2012

    10 Conley RR, "Time to clozapine response in a standardized trial" 154 : 1243-1247, 1997

    11 Kay SR, "The positive and negative syndrome scale(PANSS)for schizophrenia" 13 : 261-, 1987

    12 Shah P, "The impact of delay in clozapine initiation on treatment outcomes in patients with treatment-resistant schizophrenia : a systematic review" 268 : 114-122, 2018

    13 Kinon BJ, "The group of treatment resistant schizophrenias. Het erogeneity in treatment resistant schizophrenia (TRS)" 9 : 757-, 2019

    14 Kane JM, "The expert consensus guideline series. Optimizing pharmacologic treatment of psychotic disorders. Introduction: methods, commentary, and summary" 64 : 5-19, 2003

    15 Yoshimura B, "The critical treatment window of clozapine in treatment-resistant schizophrenia : secondary analysis of an observational study" 250 : 65-70, 2017

    16 Perkins DO, "Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia : a critical review and meta-analysis" 162 : 1785-1804, 2005

    17 National Collaborating Centre for Mental Health (UK)., "Psychosis and schizophrenia in adults: treatment and management" National Institute for Health and Care Excellence (UK) 2014

    18 Taylor DM, "Prior antipsychotic prescribing in patients currently receiving clozapine : a case note review" 64 : 30-34, 2003

    19 Gee S, "Practitioner attitudes to clozapine initiation" 130 : 16-24, 2014

    20 Lehman AF, "Practice guideline for the treatment of patients with schizophrenia" 161 (161): 1-56, 2004

    21 Hayhurst KP, "Postcode prescribing for schizophrenia" 182 : 281-283, 2003

    22 Wheeler AJ, "Pathway to clozapine use : a comparison between a patient cohort from New Zealand and a cohort from the United Kingdom" 34 : 203-211, 2014

    23 Wheeler A, "Outcomes for schizophre nia patients with clozapine treatment: how good does it get?" 23 : 957-965, 2009

    24 Young CR, "Management of the adverse effects of clozapine" 24 : 381-, 1998

    25 Laker M, "Long-term outcome with clozapine : comparison of patients continuing and discontinuing treatment" 13 : 75-78, 1998

    26 Leucht S, "Linking the PANSS, BPRS, and CGI: clinical implications" 31 : 2318-2325, 2006

    27 Jung Suk Lee, "Korean Medication Algorithm for Schizophrenia 2019, Second Revision: Treatment of Psychotic Symptoms" 대한정신약물학회 18 (18): 386-394, 2020

    28 Gillespie AL, "Is treatment-resistant schizophrenia categorically distinct from treatmentresponsive schizophrenia? A systematic review" 17 : 1-14, 2017

    29 Guy W, "ECDEU assessment manual for psychopharmacology" National Institute of Mental Health 1976

    30 Altamura A, "Duration of untreated psychosis as a predictor of outcome in first-episode schizophrenia : a retrospective study" 52 : 29-36, 2001

    31 Griffiths K, "Demographic and clinical variables associated with response to clozapine in schizophrenia : a systematic review and meta-analysis" 51 : 376-386, 2021

    32 Okhuijsen-Pfeifer C, "Demographic and clinical features as predictors of clozapine response in patients with schizophrenia spectrum disorders : a systematic review and meta-analysis" 111 : 246-252, 2020

    33 Thien K, "Delays and barriers to the commencement of clozapine in eligible people with a psychotic disorder : a literature review" 13 : 18-23, 2019

    34 Üçok A, "Delayed initiation of clozapine may be related to poor response in treatment-resistant schizophrenia" 30 : 290-295, 2015

    35 Leucht S, "Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis" 382 : 951-962, 2013

    36 Shah P, "Clozapine response trajectories and predictors of non-response in treatment-resistant schizophrenia : a chart review study" 270 : 11-22, 2020

    37 Cirulli G, "Clozapine prescribing in adolescent psychiatry : survey of prescribing practice in in-patient units" 29 : 377-380, 2005

    38 Kane J, "Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine" 45 : 789-796, 1988

    39 Iqbal MM, "Clozapine : a clinical review of adverse effects and management" 15 : 33-48, 2003

    40 Norman R, "Canadian treatment guidelines on psychosocial treatment of schizophrenia in adults" 62 : 617-623, 2017

    41 Farooq S, "Barriers to using clozapine in treatment-resistant schizophrenia : systematic review" 43 : 8-16, 2019

    42 Meltzer HY, "Age at onset and gender of schizophrenic patients in relation to neuroleptic resistance" 154 : 475-482, 1997

    43 Howes OD, "Adherence to treatment guidelines in clinical practice : study of antipsychotic treatment prior to clozapine initiation" 201 : 481-485, 2012

    44 Meltzer HY, "A randomized, double-blind comparison of clozapine and highdose olanzapine in treatment-resistant patients with schizophrenia" 69 : 274-285, 2008

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    2013-01-01 등재 등재후보 1차 FAIL (등재후보1차) KCI등재후보
    2012-02-02 학회명변경 한글명 : 대한정신분열병학회 -> 대한조현병학회 KCI등재후보
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