TY - JOUR
T1 - Safety of antipsychotics for the treatment of schizophrenia
T2 - a focus on the adverse effects of clozapine
AU - De Berardis, Domenico
AU - Rapini, Gabriella
AU - Olivieri, Luigi
AU - Di Nicola, Domenico
AU - Tomasetti, Carmine
AU - Valchera, Alessandro
AU - Fornaro, Michele
AU - Di Fabio, Fabio
AU - Perna, Giampaolo
AU - Di Nicola, Marco
AU - Serafini, Gianluca
AU - Carano, Alessandro
AU - Pompili, Maurizio
AU - Vellante, Federica
AU - Orsolini, Laura
AU - Martinotti, Giovanni
AU - Di Giannantonio, Massimo
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Clozapine, a dibenzodiazepine developed in 1961, is a multireceptorial atypical antipsychotic approved for the treatment of resistant schizophrenia. Since its introduction, it has remained the drug of choice in treatment-resistant schizophrenia, despite a wide range of adverse effects, as it is a very effective drug in everyday clinical practice. However, clozapine is not considered as a top-of-the-line treatment because it may often be difficult for some patients to tolerate as some adverse effects can be particularly bothersome (i.e. sedation, weight gain, sialorrhea etc.) and it has some other potentially dangerous and life-threatening side effects (i.e. myocarditis, seizures, agranulocytosis or granulocytopenia, gastrointestinal hypomotility etc.). As poor treatment adherence in patients with resistant schizophrenia may increase the risk of a psychotic relapse, which may further lead to impaired social and cognitive functioning, psychiatric hospitalizations and increased treatment costs, clozapine adverse effects are a common reason for discontinuing this medication. Therefore, every effort should be made to monitor and minimize these adverse effects in order to improve their early detection and management. The aim of this paper is to briefly summarize and provide an update on major clozapine adverse effects, especially focusing on those that are severe and potentially life threatening, even if most of the latter are relatively uncommon.
AB - Clozapine, a dibenzodiazepine developed in 1961, is a multireceptorial atypical antipsychotic approved for the treatment of resistant schizophrenia. Since its introduction, it has remained the drug of choice in treatment-resistant schizophrenia, despite a wide range of adverse effects, as it is a very effective drug in everyday clinical practice. However, clozapine is not considered as a top-of-the-line treatment because it may often be difficult for some patients to tolerate as some adverse effects can be particularly bothersome (i.e. sedation, weight gain, sialorrhea etc.) and it has some other potentially dangerous and life-threatening side effects (i.e. myocarditis, seizures, agranulocytosis or granulocytopenia, gastrointestinal hypomotility etc.). As poor treatment adherence in patients with resistant schizophrenia may increase the risk of a psychotic relapse, which may further lead to impaired social and cognitive functioning, psychiatric hospitalizations and increased treatment costs, clozapine adverse effects are a common reason for discontinuing this medication. Therefore, every effort should be made to monitor and minimize these adverse effects in order to improve their early detection and management. The aim of this paper is to briefly summarize and provide an update on major clozapine adverse effects, especially focusing on those that are severe and potentially life threatening, even if most of the latter are relatively uncommon.
KW - adverse effects
KW - clozapine
KW - life threatening
KW - management
KW - resistant schizophrenia
KW - NEUROLEPTIC MALIGNANT SYNDROME
KW - INDUCED GASTROINTESTINAL HYPOMOTILITY
KW - TREATMENT-RESISTANT SCHIZOPHRENIA
KW - COLONY-STIMULATING FACTOR
KW - INDUCED WEIGHT-GAIN
KW - TORSADE-DE-POINTES
KW - INDUCED AGRANULOCYTOSIS
KW - 2ND-GENERATION ANTIPSYCHOTICS
KW - INDUCED MYOCARDITIS
KW - IN-VITRO
U2 - 10.1177/2042098618756261
DO - 10.1177/2042098618756261
M3 - (Systematic) Review article
SN - 2042-0986
VL - 9
SP - 237
EP - 256
JO - Therapeutic Advances in Drug Safety
JF - Therapeutic Advances in Drug Safety
IS - 5
ER -