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Comparative study of the side-effect profile between clozapine and non-clozapine patients

Published online by Cambridge University Press:  23 March 2020

S. Ramos Perdigues
Affiliation:
Hospital Can Misses, Psychiatry, Ibiza, Spain
A. Mane Santacana
Affiliation:
Hospital Del Mar, Psychiatry, Barcelona, Spain
P. Salgado Serrano
Affiliation:
Hospital Del Mar, Psychiatry, Barcelona, Spain
E. Jove Badia
Affiliation:
Centre Dr. Emili Mira, Psychiatry, Santa Coloma De Gramanet, Spain
X. Valiente Torrelles
Affiliation:
Centre Dr. Emili Mira, Psychiatry, Santa Coloma De Gramanet, Spain
L. Ortiz Sanz
Affiliation:
Centre Dr. Emili Mira, Psychiatry, Santa Coloma De Gramanet, Spain
F. Dinamarca
Affiliation:
Centre Dr. Emili Mira, Psychiatry, Santa Coloma De Gramanet, Spain
J.R. Fortuny Olive
Affiliation:
Centre Dr. Emili Mira, Psychiatry, Santa Coloma De Gramanet, Spain
V. Perez Sola
Affiliation:
Hospital Del Mar, Psychiatry, Barcelona, Spain
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Abstract

Introduction

For resistant schizophrenia, the only approved treatment is clozapine. However, clozapine is underused, mainly due to its wide range of side-effects. Secondary effects differ amongst antipsychotics (Leucht et al., 2009). Despite that there is no good evidence that combined antipsychotics offer any advantage over the use of a single antipsychotic, combination increases the frequency of adverse events (Maudsley guidelines).

Objectives

To compare the side-effect profile between clozapine and non-clozapinepatients.

Aims

To provide evidence that clozapine patients do not show a worse side-effects profile.

Methods

We cross-sectionally analysed all patients from a Spanish long-term mental care facility (n = 139). Schizophrenic/schizoaffective patients were selected (n = 118) and their treatment was assessed, 31 patients used clozapine. We paired clozapine and non-clozapine patients by sex and age and assessed antipsychotic side effects and possible confounder variables.

Results

Our sample was 27 clozapine patients and 29 non-clozapine patients. 67,9% were male with a mean age of 51.3 (SD 9.6) years. For continuous variables: age, BMI, waist/hip, cholesterol, TG, glucose, prolactin, heart-rate, blood pressure, sleeping hours, the only statistical differences found were lower heart-rate (P = 0.001) in clozapine group and higher salivation subscale of SAS (P = 0.002) in clozapine group. For discrete variables: monotherapy, obesity, overweight, metabolic syndrome or possible confounders as propranolol, laxative, diet, antiglycemiant or insulin, fibrates or statins, antihypertensive or anticholinergic, no statistical differences were found.

Conclusions

We did not find differences in cardiometabolic parameters, which are the main barrier to prescribing clozapine, probably due to the concomitant use of other drugs in both groups.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EW549
Copyright
Copyright © European Psychiatric Association 2014

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