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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >The low down: clinical response complicated by tonic-clonic seizures on low-dose clozapine
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The low down: clinical response complicated by tonic-clonic seizures on low-dose clozapine

机译：低下：低剂量氯氮平的临床反应并发强直阵挛性发作

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Clozapine is the only second-generation antipsy-chotic that has proven efficacy greater than all other antipsychotics [1]. Somewhat ironically, it is also the antipsychotic with potentially the most dangerous side-effect profile, with agranulocytosis, gut dysmo-tility and seizures being potentially fatal side-effects. This has led to a degree of caution in its prescription. The first two of these are monitored by blood testing and clinical exam, respectively, but it is more difficult to predict if clozapine will induce a seizure in patients. A variety of approaches to reduce the risk of seizures are used clinically. The two most common methods are prophylaxis with sodium valproate if plasma levels >500 mug L or dosages are > 600 mg day[2]. There is no widely accepted international norm. This may be because the mechanism by which clozapine induces seizures is uncertain but clearly dose related [3], and for this reason clinicians have become increasingly conscious of this at high doses. Reported here is a case of clozapine-induced seizures and clinical response at low dose.
机译：氯氮平是唯一被证明比其他所有抗精神病药物疗效更高的第二代抗剖析药物[1]。具有讽刺意味的是，它也是具有潜在最危险副作用的抗精神病药，其中粒细胞缺乏症，肠道运动障碍和癫痫发作可能是致命的副作用。这在其处方中引起了一定程度的谨慎。其中的前两个分别通过血液测试和临床检查进行监测，但是很难预测氯氮平是否会诱发患者的癫痫发作。临床上使用了多种降低癫痫发作风险的方法。如果血浆水平> 500杯升或剂量> 600毫克/天，则最常用的两种方法是丙戊酸钠的预防[2]。没有广泛接受的国际规范。这可能是因为氯氮平诱发癫痫发作的机制尚不确定，但与剂量明显相关[3]，因此，临床医生越来越意识到高剂量。此处报道的是低剂量氯氮平诱发的癫痫发作和临床反应的病例。

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