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Rapid Clozapine Titration in Patients with Treatment Refractory Schizophrenia

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Abstract

The aim of this study is to evaluate the safety and effectiveness of rapid clozapine titration in patients with schizophrenia in hospital settings. We conducted a retrospective two-center cohort study to compare the safety and effectiveness of clozapine with different titration rates in treatment-refractory patients with schizophrenia. In the first center, clozapine was started at 25–50 mg followed by 50–100 mg as needed every 6 h on day 1, followed by increases of 50–100 mg/day. In the second center, titration was slower; clozapine initiated with 12.5–50 mg on day 1 followed by increases of 25–50 mg/day. The number of days between starting of clozapine until discharge was shorter in the rapid titration group (22.4 ± 8.72 vs 27.0 ± 10.5, p = 0.1). Number of days of total hospital stay were significantly shorter in the rapid titration group (29.6 ± 10.6 vs 41.2 ± 14.8, p = 0.002). Hypotension was more common in the rapid titration group and one patient had suspected myocarditis. Rapid clozapine titration appeared safe and effective. The length of stay following initiation of clozapine was shorter in the rapid-titration group, although this was not statistically significant. However starting clozapine earlier together with rapid titration has significantly shortened the length of hospital stay in patients with treatment refractory schizophrenia.

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Authors and Affiliations

  1. Department of Psychiatry, Cerrahpaşa Faculty of Medicine, University of Istanbul, Istanbul, Turkey

    Cana Aksoy Poyraz, Nazife Gamze Usta Sağlam, Şenol Turan, Burç Çağrı Poyraz & Alaattin Duran

  2. Bakırköy Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey

    Armağan Özdemir & Nesrin Tomruk

Authors
  1. Cana Aksoy Poyraz
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  2. Armağan Özdemir
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  3. Nazife Gamze Usta Sağlam
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  4. Şenol Turan
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  5. Burç Çağrı Poyraz
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  6. Nesrin Tomruk
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  7. Alaattin Duran
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Correspondence to Cana Aksoy Poyraz.

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The authors declare that there is no conflict of interest.

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This research received no specific grants from any funding agency in the public, commercial, or not-for-profit sectors.

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Poyraz, C.A., Özdemir, A., Sağlam, N.G.U. et al. Rapid Clozapine Titration in Patients with Treatment Refractory Schizophrenia. Psychiatr Q 87, 315–322 (2016). https://doi.org/10.1007/s11126-015-9394-y

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  • DOI: https://doi.org/10.1007/s11126-015-9394-y

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