• PDF / 169,992 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 36 Downloads / 154 Views

DOWNLOAD

REPORT

---

1 S

Lack of efficacy: case report A 55-year-old man exhibited lack of efficacy with clozapine and haloperidol, while being treated for schizophrenia. The man was in-patient with a long history of schizophrenia. He was receiving clozapine 350mg daily for many years. Due to acute psychotic episode with intermittent catatonic symptoms, he was hospitalised, and the dose of clozapine was increased to 400 mg/day, and haloperidol was also initiated [not all dosages stated; routes not stated]. However, no improvement in psychopathology was observed (lack of efficacy). Moreover, the patient remained hostile and reported imperative and commenting voices, forcing him to refuse his medication and to stop eating and drinking. Consequently, his general and nutritional condition worsened. Around the same time, he discontinued smoking. He then received several dosages of clozapine 225 mg/day) and haloperidol (6 mg/day, partly intravenously and in combination with lorazepam) as part of a coercive psychiatric treatment. Due to the life-threatening conditions, clozapine and haloperidol were administered via a gastric tube for 3 days. Afterwards, a percutaneous endoscopic gastrostomy (PEG) was inserted. In the next days, his nutritional and general condition improved, and hypoalbuminaemia was compensated. Nutrition, fluids, and antipsychotic medication with clozapine and haloperidol were then administered for almost 3 weeks via PEG. Afterwards, fluvoxamine was started which led to a temporary improvement of the psychomotor agitation. There was no significant change in psychopathology after PEG insertion. He did not have any physical symptoms up to day 230. Later, he was transferred to an external clinic, where electroconvulsive therapy was planned. Kuzin M, et al. Changes in Clozapine Bioavailability in a Percutaneous Endoscopic Gastrostomy-Fed Patient with Treatment-Resistant Schizophrenia. Journal of Clinical 803519173 Psychopharmacology 40: 306-308, No. 3, May 2020. Available from: URL: http://doi.org/10.1097/JCP.0000000000001207

0114-9954/20/1833-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved

Reactions 5 Dec 2020 No. 1833