Pacia S V, Devinsky O
Department of Neurology, New York University School of Medicine, NY.
Neurology. 1994 Dec;44(12):2247-9. doi: 10.1212/wnl.44.12.2247.
We reviewed the incidence, clinical features, and management of all clozapine-related seizures in 5,629 patients monitored by the Clozaril Patient Management System, during the first 6 months after marketing. Seventy-one patients had generalized tonic-clonic seizures yielding a frequency of 1.3%. One patient had myoclonic seizures prior to generalization. Seizures tended to occur at low doses (< 300 mg/d) during the titration phase, and at high doses (> or = 600 mg/d) during the maintenance phase. Patients with a history of seizures or epilepsy were more likely to have seizures soon after initiation of therapy, on low doses. Twenty-nine of 37 patients (78%) who had seizures and were rechallenged with clozapine were able to continue the medication with dose reduction and more-gradual dose titration, or with the addition of an antiepileptic medication.
我们回顾了在氯氮平上市后的头6个月内，由氯氮平患者管理系统监测的5629例患者中所有与氯氮平相关的癫痫发作的发生率、临床特征及处理情况。71例患者发生全身强直阵挛性发作，发生率为1.3%。1例患者在发作泛化前有肌阵挛发作。癫痫发作倾向于在滴定阶段低剂量（<300mg/d）时发生，以及在维持阶段高剂量（≥600mg/d）时发生。有癫痫发作或癫痫病史的患者在治疗开始后不久、低剂量时更易发生癫痫发作。37例有癫痫发作且再次接受氯氮平治疗的患者中，29例（78%）能够通过减少剂量、更缓慢地滴定剂量或加用抗癫痫药物继续用药。
