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Baptista T, Serrano A, Presti APL, Fernandez-Arana A, Elkis H, Motuca M, Olmos I, Schoretsanitis G. Clozapine safety monitoring and related research in psychiatry and neurology in South America: A scoping review. Schizophr Res 2024; 268:29-33. [PMID: 37541864 DOI: 10.1016/j.schres.2023.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/20/2023] [Accepted: 07/21/2023] [Indexed: 08/06/2023]
Abstract
The quality and quantity of clozapine safety monitoring considerably differs among South American countries and mainly focus on hematological surveillance. Few studies have been conducted on other clozapine-related adverse effects (ADRs) and mainly refer to case reports and literature reviews. We retrieved thirty-nine publications on clozapine related ADRs others than neutropenia. Studies in Brazil and Venezuela accounted for 67 % of all the publications, and 8 out of 12 countries published 2 or less manuscripts. Only Chile offers serum clozapine level measurement in public institutions. Given the recently recognized role of ethnicity, gender, smoking, obesity drug interactions in optimal clozapine administration, modernization of clozapine clinical use and research in psychiatry and neurology most be broadcasted and stimulated in South American countries.
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Affiliation(s)
- Trino Baptista
- Department of Physiology, Los Andes University Medical School, Mérida, Venezuela; Medical School, Anáhuac University, Querétaro, Mexico; Neuroorigen, Querétaro, Mexico.
| | - Ana Serrano
- SAMEIN, Salud Mental Integral SAS, Medellin, Colombia.
| | | | | | - Helio Elkis
- Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
| | - Mariano Motuca
- Department of Psychiatry, School of Medicine at Universidad Nacional de Cuyo, Mendoza, Argentina; Instituto Vilapriño, Centro de Estudios, Asistencia e Investigación en Neurociencias, Mendoza, Argentina.
| | - Ismael Olmos
- Clinical Pharmacology Unit and Pharmacy Department, Vilardebó Hospital, Administración de Servicios de Salud, Montevideo, Uruguay; Clinical Pharmacology Unit and Outpatient Clinic, Vilardebó Hospital, Administración de Servicios de Salud, Montevideo, Uruguay.
| | - Georgios Schoretsanitis
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland; The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, USA.
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Ashour AA, Fahmi MK, Mohamed RN, Basha S, Binmadi N, Enan ET, Basalim A, Qahatani AA. Association between gastric reflux, obesity and erosive tooth wear among psychiatric patients. Medicine (Baltimore) 2022; 101:e28923. [PMID: 35363217 PMCID: PMC9281915 DOI: 10.1097/md.0000000000028923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/06/2022] [Indexed: 01/04/2023] Open
Abstract
The prevalence of erosive tooth wear and obesity are high in psychiatric patients and soft drink consumption is a common risk factor associated with both diseases. This study aimed to assess the association between soft drink consumption, gastric reflux, erosive tooth wear, and obesity among resident patients at the Psychiatric Hospital, Taif, Saudi Arabia.This descriptive, cross-sectional study included 223 adult psychiatric inpatients (126 male, 97 female) with a mean age of 42.3 years (± 2.2). Dental erosion detection was performed according to World Health Organization criteria. The medical evaluation included assessment of the body mass index (BMI). With appropriate sample weighting, relationships between erosive tooth wear, gastric reflux, and obesity were assessed using multivariable logistic regression.Ninety eight patients (43.9%) presented with erosive tooth wear. The mean BMI for the entire study population was 27.7 ± 6.3 kg/m2. Regression analysis showed a strong association between erosive tooth wear and chronic vomiting or bulimia (adjusted odds ratio = 2.11; 95% confidence interval [CI] = 1.98-5.07, P < .001), gastric reflux (adjusted odds ratio = 2.13; 95% CI = 1.34-6.23, P < .001), consumption of soft drinks (adjusted odds ratio = 2.14; 95% CI = 1.03-6.08, P < .001), and schizophrenia and delusional disorders (adjusted odds ratio = 2.07; 95% CI = 1.98-5.08, P < .001).This study demonstrates a significant association between erosive tooth wear prevalence and chronic vomiting or bulimia, consumption of soft drinks, and gastric reflux among resident patients at psychiatric hospital.
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Affiliation(s)
- Amal Adnan Ashour
- Department of Oral Pathology, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Mohammed Khalil Fahmi
- Department of Restorative Dentistry, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | | | - Sakeenabi Basha
- Department of Community Dentistry, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Nada Binmadi
- Department of Oral Diagnostic Science, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Enas Tawfik Enan
- Department of Dental Biomaterials, Faculty of Dentistry, Mansoura University, Egypt
| | - Alaa Basalim
- Department of Periodontology, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Abeer Al Qahatani
- Department of Operative Dentistry, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
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Ma SM, Lim J, Jiang C, Luca L. Esophagitis after Clozapine Use in a 61-Year-Old Woman with Refractory Schizophrenia. Case Rep Psychiatry 2022; 2022:7033038. [PMID: 35693728 PMCID: PMC9187460 DOI: 10.1155/2022/7033038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 04/12/2022] [Accepted: 04/18/2022] [Indexed: 11/17/2022] Open
Abstract
Clozapine-induced esophagitis has been rarely reported. We herein report a case of a 61-year-old woman with schizophrenia who developed hematemesis, fever, and tachycardia after the initiation of clozapine. An esophagogastroduodenoscopy showed esophageal mucosal ulcerations. Her gastrointestinal symptoms resolved with pantoprazole, allowing continuation of her clozapine treatment. We report here an unusual association of severe esophagitis with clozapine use.
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Affiliation(s)
- Sung Min Ma
- 1Department of Psychiatry and Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33136, USA
| | - Junghyun Lim
- 2Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33136, USA
| | - Chunsu Jiang
- 3Division of Gastroenterology, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33136, USA
| | - Luminita Luca
- 1Department of Psychiatry and Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33136, USA
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Javelot H, Dizet S, Straczek C, Langrée B, Michel B, Haffen E, Bertschy G. Enhancing the role played by clinical pharmacists in psychiatric settings to better integrate clinical psychopharmacology into the decision-making process. Therapie 2020; 76:149-156. [PMID: 33358640 DOI: 10.1016/j.therap.2020.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 07/20/2020] [Indexed: 01/29/2023]
Abstract
The importance of clinical psychopharmacological knowledge for modern psychiatric care is both well-established and underdeveloped. Although psychiatric pharmacists are identified as experts in psychopharmacotherapy based on pharmacists' overall expertise in pharmacotherapy, in real-life health settings, such is not necessarily the case. As a matter of fact, (1) pharmacists' real expertise in pharmacotherapy is mainly seen as useful to patients (as part of therapeutic education), (2) pharmacists' practice methods are usually circumscribed to the framework of quality processes (e.g. comprehensive medication management) which are not particularly useful to clinicians who have a greater need for pharmacotherapeutic skills, (3) the difficulties in terms of collaboration between pharmacists and physicians are well-known. We describe here the implementation of an alternative system of pharmacotherapy counselling inspired by case by cases in which the remote expertise of pharmacists in psychopharmacology guided prescribers towards the implementation of recommendations from the literature. This shared decision-making process integrates both the clinical elements provided by the psychiatrist and the pharmacotherapeutic information provided by the clinical psychopharmacist, to promote evidence-based medicine (algorithmic data in recommendations) and tailor-made solutions (drug-drug and drug-disease interactions) for patients. In our experience, the success of such an initiative is likely to promote the development of clinical psychopharmacology in psychiatric settings. Importantly, within this framework, the pharmacovigilance unit and psychopharmacologist are useful resources to guide the decision-making process of the pharmacist-psychiatrist duo.
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Affiliation(s)
- Hervé Javelot
- Établissement public de santé Alsace Nord, Établissement public de Santé mentale Alsace Nord (EPSAN), 67170 Brumath, France; UR 7296 laboratoire de toxicologie et pharmacologie neuro cardiovasculaire, université de Strasbourg, 67000 Strasbourg, France.
| | - Sophie Dizet
- Centre de ressources et d'expertise en psychopharmacologie (CREPP) Bourgogne Franche-Comté et service pharmacie, CHS de Sevrey, 71100 Chalon sur Saône, France
| | - Céline Straczek
- Département de pharmacie, CHU Henri Mondor, 94000 Créteil, France; Institut Mondor de recherche biomédicale, Inserm U955, équipe 15 neuropsychiatrie translationnelle, 94000 Créteil, France
| | - Bastien Langrée
- Service pharmacie, centre hospitalier Guillaume Régnier, 35000 Rennes, France
| | - Bruno Michel
- Department of pharmacy, university hospital of Strasbourg, NHC, 67000 Strasbourg, France; Faculty of pharmacy, university of Strasbourg, 67000 Strasbourg, France; UR 7296 laboratory of neuro-cardiovascular pharmacology and toxicology, university of Strasbourg, 67000 Strasbourg, France
| | - Emmanuel Haffen
- Service de psychiatrie, CIC-1431 INSERM, CHU de Besançon, 25000 Besançon, France; Laboratoire de neurosciences, université de Franche-Comté, 25000 Besançon, France
| | - Gilles Bertschy
- Pôle de psychiatrie, santé mentale & addictologie des hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France; Inserm U1114, 67000 Strasbourg, France; Fédération de médecine translationnelle de Strasbourg, université de Strasbourg, 67000 Strasbourg, France
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Javelot H, Rangoni F, Weiner L, Michel B. High-dose quetiapine and therapeutic monitoring. Eur J Hosp Pharm 2019; 26:285-287. [DOI: 10.1136/ejhpharm-2018-001605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/05/2018] [Accepted: 06/26/2018] [Indexed: 11/03/2022] Open
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