Tang Y-L, Mao P-X, Jiang F, Chen Q, Wang C-Y, Cai Z-J, Mitchell P B
Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China.
Pharmacopsychiatry. 2008 Jan;41(1):1-9. doi: 10.1055/s-2007-993224.
Clozapine remains one of the most commonly used antipsychotic medications in China. As China has the largest population internationally on clozapine treatment, its experience and research findings are of keen interest to Western psychiatrists. However, most of the related papers have hitherto been published only in Chinese language journals. Here we review mainly Chinese-language publications on the use of clozapine in China. A descriptive study based on literature identified from searches of Medline and the China National Knowledge Infrastructure (CNKI) databases (1979-2007), and other hand-picked references. Unlike the situation in other countries, clozapine is still widely used for a number of psychiatric disorders in China, though the prescription of other second-generation antipsychotics (SGAs) is also increasing. About 25-60% of all treated patients with schizophrenia receive clozapine; and clozapine is preferred by some as a first-line treatment for schizophrenia. Clozapine is also used for other conditions such as mania, treatment-resistant depression and drug abuse. The average daily dose is between 200 and 400 mg. The incidence of leukopenia is 3.92% and agranulocytosis 0.21% in China, with about one third of reported cases of patients with agranulocytosis dying. Weight gain and clozapine-associated diabetes are also commonly reported in the Chinese population. Clozapine is currently the most commonly used treatment for schizophrenia in China. Chinese psychiatrists need to pay more attention to its potential toxic side effects when they make drug choices.
氯氮平仍是中国最常用的抗精神病药物之一。由于中国接受氯氮平治疗的人口在国际上最多，其经验和研究结果受到西方精神科医生的密切关注。然而，迄今为止，大多数相关论文仅发表在中国的期刊上。在此，我们主要回顾中国关于氯氮平使用的中文出版物。这是一项描述性研究，基于从Medline和中国知网（CNKI）数据库（1979 - 2007年）检索到的文献以及其他精选参考文献。与其他国家的情况不同，在中国，氯氮平仍广泛用于多种精神疾病，尽管其他第二代抗精神病药物（SGA）的处方量也在增加。约25% - 60%接受治疗的精神分裂症患者使用氯氮平；并且氯氮平被一些人首选作为精神分裂症的一线治疗药物。氯氮平还用于其他病症，如躁狂症、难治性抑郁症和药物滥用。平均日剂量在200至400毫克之间。在中国，白细胞减少症的发生率为3.92%，粒细胞缺乏症的发生率为0.21%，约三分之一报告的粒细胞缺乏症患者死亡。体重增加和氯氮平相关糖尿病在中国人群中也较为常见。氯氮平目前是中国治疗精神分裂症最常用的药物。中国精神科医生在选择药物时需要更加关注其潜在的毒副作用。
