Xie Xiaobo, Chen Jinzhang, Song Hongli, Fan Zebin
Department of Psychiatry, The Fifth People's Hospital of Xiangtan City, Xiangtan, China.
Front Psychiatry. 2025 Jan 20;15:1533350. doi: 10.3389/fpsyt.2024.1533350. eCollection 2024.
Clozapine and chlorpromazine are widely used for treating schizophrenia. However, irregular medical follow-ups are common in patients with schizophrenia, potentially leading to long-term super-dose medication. Managing such cases poses significant challenges for clinical psychiatrists.
This report describes a 24-year-old Han Chinese male diagnosed with schizophrenia who had been taking long-term super-doses of clozapine (18-107 tablets/day, 25 mg/tablet) and chlorpromazine (7-40 tablets/day, 50 mg/tablet) for five months due to irregular medical follow-ups. Upon hospitalization, the doses of antipsychotic drugs were gradually tapered, and the medication regimen was adjusted based on the patient's previous treatment history. Comprehensive health education about schizophrenia was also provided. The patient was followed for four years, during which his psychiatric symptoms remained under partial control.
Clinicians must consider individual differences in the efficacy and adverse effects of antipsychotics and weigh the benefits and risks of combination therapy. Future efforts should focus on strengthening health education for patients with schizophrenia and their families to improve treatment compliance and outcomes.
氯氮平和氯丙嗪广泛用于治疗精神分裂症。然而,精神分裂症患者的不定期医学随访很常见,这可能导致长期超剂量用药。处理这类病例给临床精神科医生带来了重大挑战。
本报告描述了一名24岁的汉族男性,被诊断为精神分裂症,由于不定期医学随访,他长期超剂量服用氯氮平(每天18 - 107片,每片25毫克)和氯丙嗪(每天7 - 40片,每片50毫克)达五个月之久。住院后,抗精神病药物剂量逐渐减少,并根据患者既往治疗史调整用药方案。还对该患者进行了关于精神分裂症的全面健康教育。对该患者随访了四年,在此期间其精神症状得到部分控制。
临床医生必须考虑抗精神病药物疗效和不良反应的个体差异,并权衡联合治疗的利弊。未来的工作应侧重于加强对精神分裂症患者及其家属的健康教育,以提高治疗依从性和治疗效果。