Cases of patients with treatment-resistant schizophrenia treated with clozapine and sertindole
Słowa kluczowe:
schizophrenia, neurolepticsAbstrakt
Treatment-resistance to clozapine in schizophrenia is defined as the failure in achieving the appropriate therapeutic effect by the only use of adequately high dose of clozapine of (600-800 mg per day) over at least 6 weeks.
Materials/Patients: We report the cases of 3 patients (2 men and 1 woman) with the medical history suggesting the drug-resistant schizophrenia, in whom all neuroleptics available in Poland were used without any effect. Patients were treated in the Department of Psychiatry of Medical University of Lublin between 2008 and 2010. The applied combined therapy consisted of sertindole of 16-20 mg per day and clozapine of 100-600 mg per day doses.
Results: The significant improvement of the mental state was achieved during the first two months of gradually introduced treatment. The scores in CGI scale decreased from 5 to 3 points. According to the GAF scale the evaluation of the functioning improved from 30 to 70 points. With regard to positive symptoms measured by the use of BPRS-4 the significant lowering of productive symptoms from 18 to 9 points was observed. The intensity of negative symptoms measured using the BNS scale decreased meanly from 20 to 15 points. The heart function was monitored strictly according to the recommendations of the physician. Neither the QT segment nor the QTc was remarkably prolonged. No arrhythmias were observed.
Conclusion: The used combined treatment of sertindole and clozapine was found to be effective and safe for patients with treatment-resistant schizophrenia.
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