Browsing by Subject "Clozapine"

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  • Leijala, J.; Kampman, O.; Suvisaari, J.; Eskelinen, S. (2021)
    Background: Poor adherence and negative attitudes to treatment are common clinical problems when treating psychotic disorders. This study investigated how schizophrenia core symptoms and daily functioning affect treatment adherence and attitudes toward antipsychotic medication and to compare patients using clozapine or other antipsychotics. Method: A cross-sectional study with data from 275 patients diagnosed with schizophrenia spectrum disorder. Patients adherence, attitudes, insight and side-effects were evaluated using the Attitudes toward Neuroleptic Treatment scale. Overall symptomology was measured using the Brief Psychiatric Rating Scale (BPRS), the Health of the Nation Outcome Scale (HoNOS). The functioning was assessed using activities of daily living scale, instrumental activities of daily living scale and social functioning of daily living scale. Results: Self-reported treatment adherence was high. Of the patients, 83% reported using at least 75% of the prescribed medication. Having more symptoms was related with more negative attitude towards treatment. There was a modest association with functioning and treatment adherence and attitude toward antipsychotic treatment. Attitudes affected on adherence in non-clozapine but not in clozapine groups. Conclusion: Early detection of non-adherence is difficult. Systematic evaluation of attitudes toward the treatment could be one way to assess this problem, along with optimized medication, prompt evaluation of side effects and flexible use of psychosocial treatments.
  • Leijala, J.; Kampman, O.; Suvisaari, J.; Eskelinen, S. (BioMed Central, 2021)
    Abstract Background Poor adherence and negative attitudes to treatment are common clinical problems when treating psychotic disorders. This study investigated how schizophrenia core symptoms and daily functioning affect treatment adherence and attitudes toward antipsychotic medication and to compare patients using clozapine or other antipsychotics. Method A cross-sectional study with data from 275 patients diagnosed with schizophrenia spectrum disorder. Patients adherence, attitudes, insight and side-effects were evaluated using the Attitudes toward Neuroleptic Treatment scale. Overall symptomology was measured using the Brief Psychiatric Rating Scale (BPRS), the Health of the Nation Outcome Scale (HoNOS). The functioning was assessed using activities of daily living scale, instrumental activities of daily living scale and social functioning of daily living scale. Results Self-reported treatment adherence was high. Of the patients, 83% reported using at least 75% of the prescribed medication. Having more symptoms was related with more negative attitude towards treatment. There was a modest association with functioning and treatment adherence and attitude toward antipsychotic treatment. Attitudes affected on adherence in non-clozapine but not in clozapine groups. Conclusion Early detection of non-adherence is difficult. Systematic evaluation of attitudes toward the treatment could be one way to assess this problem, along with optimized medication, prompt evaluation of side effects and flexible use of psychosocial treatments.
  • Virtanen, Tomi; Eskelinen, Saana; Sailas, Eila; Suvisaari, Jaana (Helsingfors universitet, 2016)
    Background Constipation and dyspepsia are disturbing gastrointestinal symptoms that are often ignored in research on physical comorbidities of schizophrenia. Aims Our aim was to assess dyspepsia and constipation in a sample of outpatients with schizophrenia spectrum psychoses. Methods A general practitioner performed a thorough physical health check for 275 outpatients and diagnosed constipation and dyspepsia. We assessed the possible contribution of several sociodemographic, lifestyle, and clinical variables to constipation and dyspepsia using logistic regression analysis. We also assessed whether these symptoms were associated with abnormal laboratory findings. Results The prevalence of constipation was 31.3%, and of dyspepsia 23.6%. Paracetamol (OR=3.07, 95% CI 1.34–7.02) and clozapine use (OR=5.48, 95% CI 2.75–10.90), older age (OR=1.04, 95% CI 1.01–1.06), and living in sheltered housing (OR=2.49, 95% CI 1.16–5.33) were risk factors for constipation. For dyspepsia the risk factors were female sex (OR=2.10, 95% CI 1.15–3.83), non-steroidal anti-inflammatory drugs (OR=2.47, 95% CI 1.13–5.39), and diabetes medication (OR=2.42, 95% CI 1.12–5.25). Patients with dyspepsia had lower hemoglobin and hematocrit and higher glucose values than those without dyspepsia. Patients with constipation had lower thrombocyte values than patients without constipation. However, these findings were explained by factors predisposing to constipation and dyspepsia. Conclusions Clozapine use markedly increases the risk of constipation and may lead to life-threatening complications. In addition, analgesics and diabetes medication were related to gastrointestinal symptoms. These medications and their association to gastrointestinal symptoms should be kept in mind when treating patients with schizophrenia.
  • Kontro, Mika; Lehto, Minna (2018)
  • Kettunen, Raimo; Suvisaari, Jaana; Tiihonen, Jari; Ruskoaho, Heikki; Huikuri, Heikki (2020)
    Monet masennus- ja psykoosilääkkeet pidentävät QT-aikaa ja voivat siten altistaa käyttäjänsä äkkikuolemalle. Näiden lääkkeiden aloitus edellyttää riskinarviointia ja jatkuva käyttö muun muassa EKG-seurantaa. Varsinkin klotsapiini voi aiheuttaa kardiomyopatian tai ennen sitä myokardiitin, jonka ilmetessä lääkitys kannattaa keskeyttää. Monet psykoosilääkkeet huonontavat kardiologista riskiprofiilia, sillä ne lisäävät painoa ja muuttavat glukoosi- ja lipidiaineenvaihduntaa. Psyykenlääkehoitoja aloitettaessa kannattaa tehdä kardiovaskulaarinen riskinarvio, ja heti, kun potilaan psyykkinen tila sen sallii, puuttua erityisesti tupakointiin ja painon lisääntymiseen elintapainterventiolla tai jopa lääkitystä muuttamalla. Psyykenlääkkeiden sekä sydän- ja verisuonitautilääkkeiden välillä esiintyy merkittäviä yhteisvaikutuksia. Eräät masennuslääkkeet voivat aiheuttaa vuotokomplikaatioita tukosta estävien lääkkeiden ja antikoagulanttien kanssa. Yhteisvaikutusriski on erityisen suuri monilääkityillä vanhuksilla.
  • Molins, C.; Roldan, A.; Corripio, I.; Isohanni, M.; Miettunen, J.; Seppala, J.; Seppala, A.; Koponen, Hannu; Moilanen, J.; Jaaskelainen, E.; M-RESIST Grp (2016)