Chest Pain in a Psychiatric Patient Due to Clozapine-Induced Myopericarditis

Drug-induced myocarditis is a rare, but underrecognized complication of clozapine therapy for schizophrenia. We present a case of clozapine-induced myocarditis with recovery of cardiac function after drug cessation and summarize the literature to highlight the variable presentation of this condition.

Predictors of laxative use in inpatients with schizophrenia on clozapine

Objectives: Constipation, a clinical manifestation of gastrointestinal hypomotility, is a common and potentially serious complication of clozapine therapy, requiring laxatives for its prevention and treatment. We explored the predictive factors of the increased laxative use in inpatients receiving a long-term clozapine therapy. Methods: In the cross-sectional study of 93 patients in a psychiatric rehabilitation hospital, we examined a four-week prevalence of laxative use and a range of demographic and clinical factors associated with the number of prescribed laxatives. Results: Seventy-four percent of inpatients with schizophrenia were prescribed laxatives, and they were statistically significant older and taking higher daily doses of clozapine. In generalized Poisson regression analysis, the clozapine dose, age, and comorbid diabetes mellitus and hypothyroidism were independently associated with the number of concurrently used laxatives. No association was found between the laxatives and gender, duration of clozapine treatment, and the number of other medications with a potential to cause constipation. Conclusion: The clozapine dose, age, diabetes mellitus, and hypothyroidism were shown to be the independent predictors of the increased laxative use among inpatients on clozapine and might be associated with the increased risk of clozapine-induced constipation and gastrointestinal hypomotility.

Liposomes: A Novel Carrier for Targeted Delivery of Active Agents against Schizophrenia

Schizophrenia is a severe brain disorder in which people have abnormal perceptions of reality. Schizophrenia can cause hallucinations, delusions, and extremely disordered thinking and behavior. Schizophrenia, contrary to popular belief, is not a split or multiple personality disorder. The term "schizophrenia" literally means "split mind," but it refers to a disruption in the normal balance of thoughts. Clozapine is currently the only medication approved by the USFDA for the treatment of refractory schizophrenia. However, for patients who do not respond to clozapine or for whom clozapine therapy fails to treat refractory schizophrenia, a combination of antipsychotics is used. Overall, the focus of this article is to summaries the most recent findings and news concerning liposome technology in the treatment of neurodegenerative diseases, as well as to demonstrate the potential of this technology for the development of novel therapeutics and the potential applications of liposomes in the two most common Schizophrenia disorders.

Routine clozapine assay monitoring to improve the management of treatment-resistant schizophrenia

Aims and method Routine therapeutic drug monitoring in clozapine therapy has previously not been considered justifiable. Using observational data, the clinical utility of annual clozapine assay monitoring is explored within a large mental health trust. Results After the introduction of routine monitoring, the rate of clozapine assays rose to 2.3 per patient per year, with a consistent reduction in high-risk clozapine assays (<0.1 mg/L or >1.0 mg/L or any result more than 24 months old). High-risk assays are associated with a mortality rate of 31.6 deaths per 1000 patients, more than twice that of those within the target range (0.35–0.60 mg/L and conducted within the past 12 months) (P = 0.048). Clinical implications Routine clozapine assay monitoring has significant clinical utility. Our simple but targeted approach can be readily implemented to reduce the number of patients with high-risk clozapine assay levels, potentially reduce all-cause mortality and provide optimal treatment for those with treatment-resistant schizophrenia.