Kikuchi Yuki, Yada Yuji, Otsuka Yuji, Ito Fumiaki, Tanifuji Hiroaki, Komatsu Hiroshi, Tomita Hiroaki
Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.
Department of Psychiatry, Kodama Hospital, Ishinomaki, Miyagi, Japan.
Schizophrenia (Heidelb). 2023 Nov 20;9(1):82. doi: 10.1038/s41537-023-00412-6.
Clozapine-induced fever marks the beginning of its inflammatory and potentially life-threatening adverse effects, such as myocarditis. We retrospectively analyzed the correlation between clozapine titration rate and fever onset date in 254 Japanese patients, including 55 with treatment-resistant schizophrenia who developed clozapine-induced fever. Pearson's product-moment correlation indicated a significant delay in the fever onset date with slower titration. Most fever onset cases occurred within 4 weeks, even with slow titration. Therefore, clinicians should remain vigilant in monitoring clozapine-induced fever within 4 weeks of clozapine initiation, regardless of the titration rate.
氯氮平所致发热标志着其炎症性及潜在危及生命的不良反应（如心肌炎）的开始。我们回顾性分析了254例日本患者中氯氮平滴定速率与发热起始日期之间的相关性，其中包括55例出现氯氮平所致发热的难治性精神分裂症患者。Pearson积差相关分析表明，滴定速率较慢时发热起始日期显著延迟。即使滴定速率较慢，大多数发热起始病例仍发生在4周内。因此，无论滴定速率如何，临床医生在氯氮平起始治疗的4周内都应保持警惕，监测氯氮平所致发热。
