氯氮平在老年人中的安全性。
The safety of clozapine in the elderly.
作者信息
Gareri Pietro, De Fazio Pasquale, Russo Emilio, Marigliano Norma, De Fazio Salvatore, De Sarro Giovambattista
机构信息
University "Magna Graecia" of Catanzaro, "Mater Domini" University Hospital, Clinical Pharmacology and Pharmacovigilance Unit, Faculty of Medicine and Surgery, Department of Experimental and Clinical Medicine, Catanzaro, Italy.
出版信息
Expert Opin Drug Saf. 2008 Sep;7(5):525-38. doi: 10.1517/14740338.7.5.525.
BACKGROUND
Clozapine was the first atypical 'broad spectrum' antipsychotic drug to be marketed and the first agent approved for the treatment of schizophrenia refractory to other medications. It is also effective for the treatment of aggressive behaviour in schizophrenic and demented patients and in the management of psychosis and aggression in Parkinson's disease and Lewy body dementia.
OBJECTIVE
The aim of this review is to study the safety of clozapine for use in elderly patients.
METHODS
An extensive Medline search was made. Some studies that were referenced in reports from our pharmacovigilance centre and from regulatory agencies such as the FDA, EMEA and WHO were included.
CONCLUSIONS
Clozapine treatment in the elderly requires a careful geriatric assessment. However, its use is strongly limited by the possibility of onset of severe adverse effects such as potentially fatal agranulocytosis, myocarditis and others such as seizures, weight gain and metabolic adverse effects.
背景
氯氮平是第一种上市的非典型“广谱”抗精神病药物，也是第一种被批准用于治疗对其他药物难治的精神分裂症的药物。它还对治疗精神分裂症和痴呆患者的攻击行为以及帕金森病和路易体痴呆的精神病和攻击行为有效。
目的
本综述的目的是研究氯氮平在老年患者中使用的安全性。
方法
进行了广泛的医学文献数据库检索。纳入了我们药物警戒中心以及美国食品药品监督管理局、欧洲药品管理局和世界卫生组织等监管机构报告中引用的一些研究。
结论
老年患者使用氯氮平需要进行仔细的老年医学评估。然而，其使用受到严重不良反应发生可能性的强烈限制，如潜在致命的粒细胞缺乏症、心肌炎以及其他如癫痫发作、体重增加和代谢不良反应。
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