As managing COVID-19 complications has become more prevalent in psychiatry, its effects can range from provoking new illnesses in previously healthy individuals to inducing relapses in patients in remission. However, an aspect of COVID-19's influence that is not well documented is its effect on medication responsiveness. In this case, we present a 28-year-old male diagnosed with treatment-resistant schizophrenia for eight years. While in remission on a maintenance dose of clozapine, he was admitted to the hospital with signs of severe psychosis after testing positive for COVID-19. On admission, he did not have any other major stressors and no prior comorbidities that could have induced the relapse. Despite being on a higher dose of clozapine for four weeks while hospitalized, the patient's psychosis did not improve. This raises the question if his infection had altered his response to medication that previously brought on remission.
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http://dx.doi.org/10.7759/cureus.29845 | DOI Listing |
Catatonia is one of the most severe psychiatric syndromes, and clinical symptoms and etiology are very heterogeneous. When accompanied by autonomic instability and hyperthermia it’s termed malignant catatonia, which left untreated is associated with significant morbidity and mortality. First-line treatment is high dose benzodiazepines, followed by electroconvulsive therapy (ECT), in case of non-response.
View Article and Find Full Text PDFClin Chim Acta
February 2025
Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan; Department of Psychiatry, Kodama Hospital, Ishinomaki, Miyagi, Japan. Electronic address:
J Clin Psychopharmacol
December 2024
Human Molecular Genetics Laboratory, Institut Pasteur de Montevideo, Montevideo, Uruguay.
Purpose/background: Clozapine is the recommended drug for treatment-resistant schizophrenia. Drug response could be affected by numerous factors such as age, sex, body mass index, co-medication, consumption of xanthine-containing beverages, smoking, and genetic variants of the enzymes involved in clozapine metabolism (CYP1A2, CYP3A4, and, to a lesser extent, CYP2C19 and CYP2D6). This study evaluated genetic and nongenetic variables that may affect clozapine plasma concentrations in Uruguayan patients with schizophrenia.
View Article and Find Full Text PDFClozapine treatment continues to be recognized as the gold standard for managing treatment-resistant schizophrenia. Combining clozapine with other antipsychotics (i.e.
View Article and Find Full Text PDFCNS Spectr
December 2024
Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
Introduction And Objectives: Clozapine is the antipsychotic medication with the greatest efficacy in treatment-resistant schizophrenia (TRS). Unfortunately, clozapine is ceased in approximately 0.2% to 8.
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