Polypharmacy to Clozapine Monotherapy in Treatment-Resistant Schizophrenia: A Case Report and Review of the Literature.

Autor:	Bokhari SA; Psychiatry, Al Amal Psychiatric Hospital, Emirates Health Services, Dubai, ARE., Lutfi L; Psychiatry and Behavioral Sciences, Al Amal Psychiatric Hospital, Emirates Health Services, Dubai, ARE., Elnoor M; Psychiatry, Al Amal Psychiatric Hospital, Emirates Health Services, Dubai, ARE., Mujahid B; Psychiatry, Al Amal Psychiatric Hospital, Emirates Health Services, Dubai, ARE., Osman A; Psychiatry, Al Amal Psychiatric Hospital, Emirates Health Services, Dubai, ARE.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jul 04; Vol. 16 (7), pp. e63871. Date of Electronic Publication: 2024 Jul 04 (Print Publication: 2024).
DOI:	10.7759/cureus.63871
Abstrakt:	This case report discusses a 25-year-old Middle Eastern female with a 14-year history of schizophrenia, managed as an inpatient for nearly eight years. Initially referred to a psychiatrist at age 12, with one-year-long concerns about preoccupation with the idea of having a serious illness, depressed mood, decreased appetite, social withdrawal, and aggression, she underwent multiple admissions, various medication combinations, and electroconvulsive therapy but remained resistant to treatment until clozapine monotherapy was initiated in 2023. After starting clozapine, improvements were noted in speech, communication, and eye contact, though negative symptoms and bouts of aggression persisted. This case highlights the efficacy of clozapine monotherapy in managing treatment-resistant schizophrenia after years of ineffective polypharmacy treatment. The importance of clozapine in treating treatment-resistant schizophrenia cannot be understated. Despite its efficacy, clozapine is often underutilised globally due to concerns about adverse effects and the need for blood monitoring, leading to the overuse of antipsychotic polypharmacy. This polypharmacy is associated with higher adverse event rates, increased costs, and uncertain long-term safety. This case report demonstrates the successful management of treatment-resistant schizophrenia with clozapine monotherapy. The patient's significant improvement supports the need to prioritise clozapine, highlighting its benefits over polypharmacy and advocating for its broader use to enhance patient outcomes. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Bokhari et al.)
Databáze:	MEDLINE
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