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Evaluating the adverse drug reactions to clozapine in populations of children and adolescents: insights from VigiBase data.
Eur Child Adolesc Psychiatry
December 2024
Mental Health Research Center, Eastern State Hospital, Lexington, KY, USA.
Article Synopsis
- Clozapine use is primarily associated with the risk of neutropenia, but there is limited research on adverse drug reactions (ADRs) and fatal outcomes in patients under 18 years old.
- A study analyzed 2,825 reports of clozapine usage in this age group, revealing 42 fatal outcomes, with the most common ADR being decreased white blood cell count, while suicide was a significant cause of non-duplicated fatalities.
- To better prevent fatal outcomes in young patients, child and adolescent psychiatrists should broaden their focus beyond severe neutropenia to include other serious ADRs like pneumonia, while still being cautious of the risk of overdose in those at risk for suicide.
Significant haematological alterations in clozapine-treated patients: prevalence and clinical correlation.
Acta Neuropsychiatr
November 2024
Department of Psychiatry, Firat University School of Medicine, Elazig, Turkey.
Objectives: Clozapine is an atypical antipsychotic crucial for treatment-resistant schizophrenia, characterised by its multi-receptor targeting, including serotonin (5-HT2A, 5-HT2C) and dopamine (D1, D2, D3, D4) receptors, among others. This broad mechanism is effective against positive symptoms of schizophrenia with a lower incidence of extrapyramidal side effects. However, clozapine poses significant haematological risks, notably agranulocytosis, necessitating stringent blood monitoring protocols.
View Article and Find Full Text PDFPharmacovigilance in Action: Utilizing VigiBase Data to Improve Clozapine Safety.
Patient Prefer Adherence
November 2024
Mental Health Research Center, Eastern State Hospital, Lexington, KY, USA.
Purpose: Clozapine is an antipsychotic which was approved in 1989 for treatment-resistant schizophrenia in the United States (US). There were few randomized trials before its approval and potentially lethal clozapine adverse drug reactions (ADRs), such as agranulocytosis and myocarditis were identified by pharmacovigilance. VigiBase, the WHO global database, is a cornerstone of international pharmacovigilance efforts for ADR identification during post-marketing surveillance.
View Article and Find Full Text PDFClozapine monitoring requirements: is it time for an update?
Br J Psychiatry
October 2024
Department of Psychiatry, University of Oxford, Oxford, Oxford Health NHS Foundation Trust, Oxford and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
Oloyede and colleagues advocate for updating haematological monitoring requirements for clozapine, arguing that current protocols overestimate the risk of clozapine-induced agranulocytosis. Their research suggests that stringent monitoring may unnecessarily limit access to clozapine, a crucial treatment for resistant schizophrenia. The editorial supports calls for international consensus to carefully weigh the pros and cons of relaxing monitoring guidelines while ensuring comprehensive care for patients.
View Article and Find Full Text PDFNormocytic Anemia as a Side Effect of Clozapine: A Case Report.
Cureus
August 2024
Department of Surgery, Wyckoff Heights Medical Center, Brooklyn, USA.
Article Synopsis
- This case report discusses an unusual side effect—anemia—related to clozapine, an atypical antipsychotic used for treatment-resistant schizophrenia.
- A 70-year-old male patient experienced declining hemoglobin levels during clozapine treatment, despite regular blood monitoring that typically focuses on neutrophil counts.
- The anemia was likely due to clozapine, with suggestions of potential bone marrow toxicity, highlighting the need for comprehensive blood work to monitor all blood parameters in patients taking this medication.
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