Teferra Solomon
Department of Psychiatry, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
S Afr J Psychiatr. 2020 Jun 24;26:1418. doi: 10.4102/sajpsychiatry.v26i0.1418. eCollection 2020.
At least one-third of patients with schizophrenia suffer from treatment-resistant schizophrenia needing treatment with clozapine. This is the first report on the experience of initiating clozapine service in Ethiopia.
The aim of this study was to report the experience of setting up clozapine service and describe characteristics of patients treated with clozapine.
This study was conducted in a general hospital in Addis Ababa, Ethiopia.
Descriptive summary of the clozapine treatment service and review of characteristics of patients treated with clozapine were conducted. Clinical Global Impression (CGI) Scale and Abnormal Involuntary Movement Scale (AIMS) score were used to measure outcome. Quantitative data were analysed using Statistical Package for the Social Sciences (SPSS) Version 24.
It was possible to provide clozapine treatment in a general hospital using the national guideline. During the first year of initiation of the service, a total of 22 patients were treated. The majority were men (20/22, 90.9%) and in the age group of 30-44 years (11/22, 50%). Indications for clozapine were treatment-resistant schizophrenia (15/22, 68.2%) and tardive dyskinesia (7/22, 31.8%). The average dose of clozapine was 350 mg/day. Common side effects included sedation, constipation and excessive salivation. On CGI Scale, mean severity index score dropped from 5.18 at admission to 3.68 during discharge, and average AIMS score changed from 16.8 to 6.5. None of the patients developed agranulocytosis; however, three patients discontinued because of adverse effects.
Establishing clozapine treatment service was possible in a general hospital in Ethiopia where psychiatric service run by psychiatrists was available. Mechanisms should be in place to ensure adherence to the national guideline.
至少三分之一的精神分裂症患者患有难治性精神分裂症，需要使用氯氮平进行治疗。这是关于在埃塞俄比亚启动氯氮平服务经验的首份报告。
本研究的目的是报告建立氯氮平服务的经验，并描述接受氯氮平治疗患者的特征。
本研究在埃塞俄比亚亚的斯亚贝巴的一家综合医院进行。
对氯氮平治疗服务进行描述性总结，并回顾接受氯氮平治疗患者的特征。使用临床总体印象量表（CGI）和异常不自主运动量表（AIMS）评分来衡量治疗结果。定量数据使用社会科学统计软件包（SPSS）24版进行分析。
按照国家指南，在综合医院提供氯氮平治疗是可行的。在服务启动的第一年，共治疗了22名患者。大多数为男性（20/22，90.9%），年龄在30 - 44岁之间（11/22，50%）。使用氯氮平的指征为难治性精神分裂症（15/22，68.2%）和迟发性运动障碍（7/22，31.8%）。氯氮平的平均剂量为350毫克/天。常见副作用包括镇静、便秘和唾液分泌过多。在CGI量表上，平均严重程度指数评分从入院时的5.18降至出院时的3.68，AIMS平均评分从16.8变为6.5。没有患者发生粒细胞缺乏症；然而，有3名患者因不良反应而停药。
在埃塞俄比亚有精神科医生提供精神科服务的综合医院建立氯氮平治疗服务是可行的。应建立相应机制以确保遵循国家指南。
