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Related Concept Videos

Drug Therapy01:28

Drug Therapy

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The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
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Psychosis: Goals of Pharmacotherapy01:26

Psychosis: Goals of Pharmacotherapy

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Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
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Psychosis and Antipsychotic Drugs: Overview

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The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic...
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Antipsychotic Drugs: Typical and Atypical Agents01:21

Antipsychotic Drugs: Typical and Atypical Agents

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Antipsychotic drugs are classified into first-generation (typical) drugs including phenothiazines; and second-generation (atypical) drugs. Chlorpromazine hydrochloride (Thorazine), a phenothiazine derivative, broadly impacts the central, autonomic, and endocrine systems. This drug, along with typical agents like haloperidol (Haldol), primarily works by antagonizing D2 receptors, thus reducing dopaminergic neurotransmission. However, typical antipsychotics can cause side effects such as sedation...
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Psychological and Sociocultural Causes of Schizophrenia01:29

Psychological and Sociocultural Causes of Schizophrenia

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Schizophrenia, a complex psychiatric disorder, has been historically misunderstood. Early psychological theories attributed its origins to childhood trauma and unresponsive parenting. However, contemporary research largely rejects these notions, favoring the vulnerability-stress hypothesis. This model proposes that individuals with a genetic predisposition to schizophrenia may develop the disorder following exposure to significant environmental stressors. Notably, studies on high-risk...
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Factors Affecting Renal Clearance: Renal Impairment01:17

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Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
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Assessing Adherence to Clozapine: Practical Considerations.

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Assessing clozapine adherence is challenging. This study found that while most patients adhere to clozapine, unexpected nonadherence occurs, highlighting the need for routine therapeutic drug monitoring (TDM).

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Area of Science:

  • Pharmacology
  • Psychiatry
  • Clinical Chemistry

Background:

  • Clinical assessment of patient adherence to clozapine treatment presents significant challenges.
  • Clozapine is a critical medication for treatment-resistant schizophrenia, where adherence is vital for efficacy and safety.

Purpose of the Study:

  • To investigate the incidence of nonadherence to clozapine therapy.
  • To evaluate the utility of therapeutic drug monitoring (TDM) in assessing clozapine adherence.

Main Methods:

  • Analysis of plasma clozapine levels in samples submitted to a clozapine TDM service between 1993 and 2017.
  • Nonadherence defined as plasma clozapine concentration below 0.01 mg L⁻¹.
  • Examination of prescribed doses and presence of norclozapine in nonadherent samples.

Main Results:

  • A low incidence of nonadherence was observed: 1.1% in men and 1.0% in women.
  • In samples without clozapine, norclozapine was detected in 9.1% of men and 6.3% of women.
  • The absence of clozapine was unexpected in most cases, despite TDM requests for specific reasons like confirming nonadherence or post-overdose clearance.

Conclusions:

  • While overall clozapine adherence appears good, loss of tolerance to its cardiovascular effects is a risk.
  • Irregular clozapine use increases self-harm risk in treatment-resistant schizophrenia.
  • Routine monthly clozapine TDM, facilitated by new immunoassay methods, is recommended for improved patient management.