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首页> 外文期刊>The journal of clinical psychiatry >Switching clozapine responders to olanzapine.
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Switching clozapine responders to olanzapine.

机译：将氯氮平响应者切换为奥氮平。

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BACKGROUND: Clozapine is an atypical antipsychotic indicated for the management of severely ill patients with schizophrenia who have failed to respond adequately to standard drug treatment. The significant risk of agranulocytosis and seizure associated with clozapine has led to the restrictions in its use. Additionally, drug-induced sedation, sialorrhea, enuresis, and weight gain are often cited as problematic consequences of clozapine treatment. Our primary objective was to determine the effectiveness and safety of a method of slow cross-titration from clozapine to olanzapine among patients responsive to clozapine treatment but experiencing medication-induced adverse events. METHOD: Changes in symptomatology, mood, subjective response, and safety were examined in 20 outpatients meeting DSM-IV criteria for schizophrenia or schizoaffective disorder who converted from clozapine to olanzapine. Patients were considered clozapine-responsive as evidenced by improved social function and decreased symptoms with clozapine therapy; however, they were interested in alternative pharmacologic treatment because of clozapine-related side effects. RESULTS: Equivalent efficacy of olanzapine to clozapine was found in 90% of the patients (18/20) in the study group, without rehospitalization or suicidal behavior in any of the patients. Also notable was a reduction in drug-induced side effects and improved subjective response to pharmacotherapy. CONCLUSION: The successful conversion from clozapine to olanzapine has the potential to provide great benefits for the patient, including reducing drug-induced side effects while maintaining symptom control. These preliminary results suggest that further research on converting clozapine responders to olanzapine is warranted.
机译：背景：氯氮平是一种非典型的抗精神病药，可用于治疗对标准药物治疗无效的严重精神分裂症患者。与氯氮平有关的粒细胞缺乏症和癫痫发作的重大风险已导致其使用限制。另外，药物诱导的镇静，流涎，遗尿和体重增加通常被视为氯氮平治疗的问题。我们的主要目标是确定在对氯氮平治疗有反应但遇到药物引起的不良事件的患者中，从氯氮平慢速滴定到奥氮平的方法的有效性和安全性。方法：检查了20名符合DSM-IV标准的精神分裂症或精神分裂症患者的症状，情绪，主观反应和安全性的变化，这些患者从氯氮平转变为奥氮平。氯氮平治疗改善了社交功能，减轻了症状，证明患者被认为对氯氮平有反应;然而，由于氯氮平相关的副作用，他们对替代药物治疗感兴趣。结果：在研究组中，有90％的患者（18/20）发现了奥氮平与氯氮平具有等效的疗效，任何患者中均未发生再次住院或自杀行为。同样值得注意的是药物引起的副作用减少和对药物治疗的主观反应得到改善。结论：从氯氮平成功转化为奥氮平具有为患者带来巨大益处的潜力，包括减少药物引起的副作用，同时保持症状控制。这些初步结果表明，有必要进一步研究将氯氮平反应剂转化为奥氮平。

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