Prescribing trends and safety of clozapine in an older persons mental health population
| Autor: | Matthew Croucher, Alice Law |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Neutropenia medicine.medical_treatment Population Drug Resistance Drug Prescriptions 03 medical and health sciences 0302 clinical medicine medicine Humans Practice Patterns Physicians' education Antipsychotic Adverse effect Clozapine Aged Retrospective Studies Cause of death Aged 80 and over education.field_of_study business.industry Medical record Middle Aged Mental health 030227 psychiatry Psychiatry and Mental health Clinical Psychology Psychotic Disorders Practice Guidelines as Topic Emergency medicine Female Observational study Geriatrics and Gerontology business Gerontology 030217 neurology & neurosurgery Antipsychotic Agents New Zealand medicine.drug |
| Zdroj: | International Psychogeriatrics. 31:1823-1829 |
| ISSN: | 1741-203X 1041-6102 |
| DOI: | 10.1017/s1041610219000255 |
| Popis: | Objectives:To provide additional data concerning the safety, effectiveness and local prescribing trends of clozapine in elderly patients.Design:Retrospective observational case-series analysis.Setting:Data were collected from the medical files of 167 patients prescribed clozapine.Participants:All patients prescribed clozapine in the last 15 years by the psychogeriatric service in Christchurch, New Zealand. The subjects were mostly aged over 65; however, patients under 65 are also accepted into the service on a case by case basis if they have an age-related health condition.Results:Twenty-five (15.0%) patients had their clozapine stopped due to a significant adverse reaction, including eleven who developed significant neutropenia. Seventy-four (44.3%) of the patients had no recorded side effects at all. Sixty-five (38.9%) of our elderly patients died while taking clozapine, though none of these deaths was felt to be related to clozapine use. Several patients safely initiated clozapine in either their own home or a nursing home without requiring hospital admission. Only two patients ceased clozapine due to ineffectiveness, and one hundred, forty-two (86.1%) of the patients had positive comments in their medical record regarding the benefits of clozapine for their particular case.Conclusions:We found clozapine could be used safely and effectively in our patient group, for a wider range of indications and at lower doses than younger patients. Data collection regarding cause of death in elderly patients who were ever prescribed clozapine was problematic, and more research into this area is required. |
| Databáze: | OpenAIRE |
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