Abstract:
:Clozapine has been found to be superior to traditional neuroleptics in the treatment of refractory schizophrenia and is increasingly being used to treat schizophrenia, affective disorders, some neurological disorders, and aggression. For many patients, clozapine offers new hope for the successful pharmacological management of a disabling mental disorder. However, up to 17 percent of patients must discontinue treatment with clozapine because of adverse effects, which also limit the rate at which the dose can be increased and the maximum dose that can be tolerated. This article reviews strategies for minimizing and managing the adverse effects of clozapine, including agranulocytosis, seizures, sedation, delirium, obsessive-compulsive symptoms, hypotension, tachycardia, weight gain, sialorrhea, elevated liver enzymes, constipation, nausea, enuresis, fever, and neuromuscular effects. Incidence and morbidity are presented first. Then, the known or hypothesized pathophysiology of the adverse effects are described. Finally, nonpharmacological and pharmacological interventions are reviewed. Under-standing the incidence, pathophysiology, and treatments of adverse effects is essential for a positive therapeutic outcome when prescribing clozapine.
journal_name
Schizophr Bulljournal_title
Schizophrenia bulletinauthors
Young CR,Bowers MB Jr,Mazure CMdoi
10.1093/oxfordjournals.schbul.a033333subject
Has Abstractpub_date
1998-01-01 00:00:00pages
381-90issue
3eissn
0586-7614issn
1745-1701journal_volume
24pub_type
杂志文章,评审abstract::Identifying distinctive subtypes of schizophrenia could ultimately enhance diagnostic and prognostic accuracy. We aimed to uncover neuroanatomical subtypes of chronic schizophrenia patients to test whether stratification can enhance computer-aided discrimination of patients from control subjects. Unsupervised, data-dr...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sby008
更新日期:2018-08-20 00:00:00
abstract::A number of recent articles, many appearing in Schizophrenia Bulletin, signal a renewed interest in phenomenological approaches to our understanding of schizophrenia. These approaches conceptualize schizophrenia as a disorder of altered self-awareness and decreased prereflective social attunement, which may manifest a...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/sbv035
更新日期:2015-11-01 00:00:00
abstract::Schizophrenia elevates the risk for aggressive behavior and violent crime, and different approaches have been used to manage this problem. The results of such treatments vary. One reason for this variation is that aggressive behavior in schizophrenia is heterogeneous in origin. This heterogeneity has usually not been ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/sbr041
更新日期:2011-09-01 00:00:00
abstract::The chronic methamphetamine (MAP) intoxication model of schizophrenia in animals is outlined. The idea originated from the clinical and neurochemical similarities between MAP psychosis and schizophrenia that were found during the decade immediately after World War II when MAP abuse occurred in epidemic proportions in ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/18.1.107
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Genome-wide association studies (GWAS) implicate single nucleotide polymorphisms (SNPs) on chromosome 6p21.3-22.1, the human leukocyte antigen (HLA) region, as common risk factors for schizophrenia (SZ). Other studies implicate viral and protozoan exposure. Our study tests chromosome 6p SNPs for effects on S...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbs087
更新日期:2012-11-01 00:00:00
abstract::The multilevel control of eye movements for the researcher in the schizophrenic disease process includes the saccadic trajectory, the dual mode tracking system, and schematically directed eye movements in fixation, in scanpaths, and other looking strategies, and in reading. Coordination of eye movements with head move...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/9.1.55
更新日期:1983-01-01 00:00:00
abstract::Sustained attention abnormality in schizophrenia is usually refractory to available treatment. Nicotine can transiently improve sustained attention in schizophrenia patients, although its neural mechanisms are unknown. Understanding the neural basis of this effect may lead to new treatment strategies for this cognitiv...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,随机对照试验
doi:10.1093/schbul/sbp089
更新日期:2011-03-01 00:00:00
abstract::Research on the effectiveness of short-term education programs in changing societal attitudes about mental illness has been mixed. Education efforts seem to be mediated by characteristics of the program participants. This study determines whether the effects of a specially prepared, semester-long course on severe ment...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a033392
更新日期:1999-01-01 00:00:00
abstract::Cognitive Enhancement Therapy (CET) is a developmental approach to the rehabilitation of schizophrenia patients that attempts to facilitate an abstracting and "gistful" social cognition as a compensatory alternative to the more demanding and controlled cognitive strategies that often characterize schizophrenia as well...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a033411
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:In light of the evidence for brain white matter (WM) abnormalities in schizophrenia, study of normal WM maturation in adolescence may provide critical insights relevant to the neurodevelopment of the disorder. Voxel-wise diffusion tensor imaging (DTI) studies have consistently demonstrated increases in fract...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,meta分析
doi:10.1093/schbul/sbs054
更新日期:2012-11-01 00:00:00
abstract::Secondary prevention in schizophrenia is still not good enough, and the authors of the articles in this issue of Schizophrenia Bulletin present important new knowledge that may increase earlier detection and treatment. This final article discusses some of their main findings in relation to clinical consequences and ne...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/22.2.347
更新日期:1996-01-01 00:00:00
abstract::Disruption of sleep/wake cycles is common in patients with schizophrenia and correlates with cognitive and affective abnormalities. Mice deficient in stable tubule only polypeptide (STOP) show cognitive, behavioral, and neurobiological deficits that resemble those seen in patients with schizophrenia, but little is kno...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbw017
更新日期:2016-09-01 00:00:00
abstract::This study compared the performance of 39 biological relatives of persons with schizophrenia to that of 30 normal adult controls on graphesthesia processing, a complex somatosensory processing task. The relatives performed significantly worse on the graphesthesia task compared to the healthy controls. The relatives an...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a007082
更新日期:2004-01-01 00:00:00
abstract::Previous studies have reported associations between childhood adversities, eg, loss of a parent, being raised in institutional care, sexual and other kinds of abuse by adults and bullying by peers, and psychosis in adulthood. However, the mechanisms by which these adversities lead to psychotic experiences are poorly u...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbs049
更新日期:2012-06-01 00:00:00
abstract::The circadian rest-activity cycle of schizophrenia patients stabilized for more than a year on monotherapy with a "classical" neuroleptic (haloperidol, flupentixol) or with the atypical neuroleptic clozapine was documented by continuous activity monitoring for 3-7 weeks. In this pilot study, the three patients treated...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a006890
更新日期:2001-01-01 00:00:00
abstract::The purpose of this study was (1) to identify the demographic and psychosocial characteristics of Korean-Americans with schizophrenia, and (2) to compare the demographic and psychosocial characteristics of Korean-Americans with schizophrenia to African-American, Latino, and Euro-American individuals with schizophrenia...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a006974
更新日期:2002-01-01 00:00:00
abstract::Thalamus abnormalities are common in neurological and psychiatric illnesses. Therefore, it is essential to understand the properties of the thalamus-related networks. The thalamic reticular nucleus (TRN) is a thin GABAergic layer interface strategically located between the thalamus and the neocortex. It is, at the ver...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbq165
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:Stressful life events have been implicated in the onset of psychotic disorders, but there are few robust studies. We sought to examine the nature and magnitude of associations between adult life events and difficulties and first-episode psychoses, particularly focusing on contextual characteristics, including...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbaa005
更新日期:2020-07-08 00:00:00
abstract::Schizophrenia is but one form of psychosis; therefore, it is important to control for the psychotic factor in studies of the schizophrenic syndrome. A survey was done of 478 articles in 15 major psychiatric and psychological journals to determine the frequency of controls for psychosis in schizophrenia research. The s...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/7.4.729
更新日期:1981-01-01 00:00:00
abstract::Numerous studies have differentiated schizophrenic patients and normal controls in electroencephalography (EEG) spectral patterns recorded at rest. We replicated the resting EEG spectral differences between these groups and observed significant differences in periodic photic stimuli on the EEG spectra. Drug-free schiz...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/16.4.627
更新日期:1990-01-01 00:00:00
abstract::Although glutamate was first hypothesized to be involved in the pathophysiology of schizophrenia in the 1980s, it was the demonstration that N-methyl-D-aspartate (NMDA) receptor antagonists, the dissociative anesthetics, could replicate the full range of psychotic, negative, cognitive, and physiologic features of schi...
journal_title:Schizophrenia bulletin
pub_type: 历史文章,杂志文章
doi:10.1093/schbul/sbs076
更新日期:2012-09-01 00:00:00
abstract::Schizophrenia has been associated with heightened stress responsivity in adolescence that precedes onset of psychosis. We now report that multiple stressors during adolescence in normal rats leads to deficits in adults analogous to that seen in schizophrenia patients. Moreover, impairment of stress control by lesion o...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/sbx033
更新日期:2017-05-01 00:00:00
abstract::Pharmacologic agents currently used or being studied for the treatment of schizophrenia are reviewed. Neuroleptic medications are still the mainstay of treatment, but recent studies suggest new approaches to dosage and to the treatment of acute psychosis. Lithium is beneficial in psychotic illnesses with acute onset a...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/9.4.504
更新日期:1983-01-01 00:00:00
abstract::The objective of this study is to compare the effectiveness among sulpiride, risperidone, olanzapine, and haloperidol by evaluating the persistence of drug use. A retrospective cohort study was conducted by analyzing the National Health Insurance Research Database of Taiwan. Patients with schizophrenia aged 18-65 year...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbs002
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Executive control of attention in schizophrenia has recently been assessed by means of the Attention Network Test (ANT). In the past, for tasks assessing executive attention, findings in schizophrenia have been contradictory, among others suggesting a lack of increased stimulus interference effects. Attentio...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbm155
更新日期:2008-11-01 00:00:00
abstract::Deluded people differ from nondeluded controls on attributional style questionnaires and probabilistic-reasoning and theory-of-mind (ToM) tasks. No study to date has examined the relations between these 3 reasoning anomalies in the same individuals so as to evaluate their functional independence and potentially inform...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbn069
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:The homicide of strangers by people with psychosis, referred to here as "stranger homicides," are rare and tragic events that generate adverse publicity for mental health services and have resulted in significant changes in mental health policy and law. AIM:To estimate the incidence of stranger homicides, u...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,meta分析
doi:10.1093/schbul/sbp112
更新日期:2011-05-01 00:00:00
abstract::To better characterize hippocampal pathophysiology in schizophrenia, we conducted a longitudinal study evaluating hippocampal functional connectivity during resting state, using seeds prescribed in its anterior and posterior regions. We enrolled 34 unmedicated patients with schizophrenia or schizoaffective disorder (S...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbv228
更新日期:2016-07-01 00:00:00
abstract::In 1994 Link and Stueve identified a number of symptoms--called threat/control-override (TCO) symptoms--that were significantly more than others related to violence. This was confirmed by some, but not all, following studies. The contradictory results could be due to remarkable differences in sample compositions, sour...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a007066
更新日期:2004-01-01 00:00:00
abstract:UNLABELLED:We aimed to discover whether metabolic complications of schizophrenia (SZ) are present in first episode (FE) and unmedicated (UM) patients, in comparison with patients established on antipsychotic medication (AP). METHOD:A systematic search, critical appraisal, and meta-analysis were conducted of studies to...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,meta分析,评审
doi:10.1093/schbul/sbs082
更新日期:2013-03-01 00:00:00