氯氮平再挑战和起始尽管中性粒细胞减少症-实用，逐步指南。
Clozapine rechallenge and initiation despite neutropenia- a practical, step-by-step guide.
机构信息
Consultant Forensic Psychiatrist, Ashworth Hospital, Mersey Care NHS Foundation Trust, Parkbourn, Maghull, Merseyside, L31 1HW, UK.
Consultant Haematologist, Arrowe Park Hospital, Arrowe Park Road, Upton, Merseyside, Wirral, CH49 5PE, UK.
出版信息
BMC Psychiatry. 2020 Jun 5;20(1):279. doi: 10.1186/s12888-020-02592-2.
Abstract
Clozapine remains the only drug treatment likely to benefit patients with treatment resistant schizophrenia. Its use is complicated by an increased risk of neutropenia and so there are stringent monitoring requirements and restrictions in those with previous neutropenia from any cause or from clozapine in particular. Despite these difficulties clozapine may yet be used following neutropenia, albeit with caution. Having had involvement with 14 cases of clozapine use in these circumstances we set out our approach to the assessment of risks and benefits, risk mitigation and monitoring with a practical guide.
摘要
氯氮平仍然是唯一可能对治疗抵抗性精神分裂症患者有益的药物治疗方法。由于其使用会增加中性粒细胞减少的风险，因此对于以前有任何原因引起的中性粒细胞减少或特别是使用氯氮平引起的中性粒细胞减少的患者，有严格的监测要求和限制。尽管存在这些困难，在中性粒细胞减少的情况下仍可能使用氯氮平，但需要谨慎。我们参与了 14 例这种情况下使用氯氮平的病例，制定了评估风险和收益、降低风险和监测的方法，并提供了实用指南。
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