A Case Report of Excessive Use of Clozapine Combined With Clonazepam
IntroductionFor patients with schizophrenia, clozapine (CLZ) in combination with clonazepam (CLNAZ) is one of the viable therapeutic options. We successfully reduced the doses of CLZ and CLNAZ to the safe range of a polydrug abuse patient. As far as we know, this is the first case of this problem. A...
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| Format: | Article |
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Frontiers Media S.A.
2022-02-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.831276/full |
| _version_ | 1818285061168955392 |
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| author | Wei Li Wei Li Yan Liu Haifeng Jiang Haifeng Jiang Jiang Du Yan Zhao Zheyi Du Shuo Li Haihong Wang |
| author_facet | Wei Li Wei Li Yan Liu Haifeng Jiang Haifeng Jiang Jiang Du Yan Zhao Zheyi Du Shuo Li Haihong Wang |
| author_sort | Wei Li |
| collection | DOAJ |
| description | IntroductionFor patients with schizophrenia, clozapine (CLZ) in combination with clonazepam (CLNAZ) is one of the viable therapeutic options. We successfully reduced the doses of CLZ and CLNAZ to the safe range of a polydrug abuse patient. As far as we know, this is the first case of this problem. As there are no relevant guidelines to reduce CLZ or CLNAZ, we hope to share this case to provide a reference for the prevention and treatment of similar patients with multidrug abuse.Case PresentationThis case report describes a 46-year-old male with a 24-year history of schizophrenia. His main clinical manifestations are auditory hallucinations, persecutory delusion, and emotional instability. In 2012, the patient started taking rifampicin due to tuberculosis and gradually overused CLZ and CLNAZ. Before admission, he took 1,275 mg of CLZ every day and 26 mg of CLNAZ every night. With the help of Therapeutic Drug Monitoring (TDM) and pharmacogenetic testing, we gradually reduced his daily dose of CLZ and CLNAZ and formulated a more reasonable dosing schedule for him. At the time of discharge, the patient took CLZ 450 mg per day and CLNAZ 2 mg per night, with no obvious symptoms of psychosis.ConclusionIn the process of drug maintenance treatment of schizophrenia, it is necessary to adopt TDM strategy to reduce and treat the abuse of multiple prescription drugs. |
| first_indexed | 2024-12-13T01:02:42Z |
| format | Article |
| id | doaj.art-3801bb2246a44d47a45554126421dbfa |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-13T01:02:42Z |
| publishDate | 2022-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-3801bb2246a44d47a45554126421dbfa2022-12-22T00:04:39ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-02-011310.3389/fpsyt.2022.831276831276A Case Report of Excessive Use of Clozapine Combined With ClonazepamWei Li0Wei Li1Yan Liu2Haifeng Jiang3Haifeng Jiang4Jiang Du5Yan Zhao6Zheyi Du7Shuo Li8Haihong Wang9Shanghai Mental Health Center, School of Medicine, Shanghai Jiaotong University, Shanghai, ChinaAlzheimer's Disease and Related Disease Center, Shanghai Jiaotong University, Shanghai, ChinaShanghai Baoshan Mental Health Center, Shanghai, ChinaShanghai Mental Health Center, School of Medicine, Shanghai Jiaotong University, Shanghai, ChinaShanghai Mental Health Center Clinical Research Center, Shanghai, ChinaShanghai Mental Health Center, School of Medicine, Shanghai Jiaotong University, Shanghai, ChinaShanghai Mental Health Center, School of Medicine, Shanghai Jiaotong University, Shanghai, ChinaShanghai Mental Health Center, School of Medicine, Shanghai Jiaotong University, Shanghai, ChinaShanghai Mental Health Center, School of Medicine, Shanghai Jiaotong University, Shanghai, ChinaShanghai Mental Health Center, School of Medicine, Shanghai Jiaotong University, Shanghai, ChinaIntroductionFor patients with schizophrenia, clozapine (CLZ) in combination with clonazepam (CLNAZ) is one of the viable therapeutic options. We successfully reduced the doses of CLZ and CLNAZ to the safe range of a polydrug abuse patient. As far as we know, this is the first case of this problem. As there are no relevant guidelines to reduce CLZ or CLNAZ, we hope to share this case to provide a reference for the prevention and treatment of similar patients with multidrug abuse.Case PresentationThis case report describes a 46-year-old male with a 24-year history of schizophrenia. His main clinical manifestations are auditory hallucinations, persecutory delusion, and emotional instability. In 2012, the patient started taking rifampicin due to tuberculosis and gradually overused CLZ and CLNAZ. Before admission, he took 1,275 mg of CLZ every day and 26 mg of CLNAZ every night. With the help of Therapeutic Drug Monitoring (TDM) and pharmacogenetic testing, we gradually reduced his daily dose of CLZ and CLNAZ and formulated a more reasonable dosing schedule for him. At the time of discharge, the patient took CLZ 450 mg per day and CLNAZ 2 mg per night, with no obvious symptoms of psychosis.ConclusionIn the process of drug maintenance treatment of schizophrenia, it is necessary to adopt TDM strategy to reduce and treat the abuse of multiple prescription drugs.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.831276/fullschizophreniaclozapineclonazepamtherapeutic drug monitoring (TDM)withdrawalcase report |
| spellingShingle | Wei Li Wei Li Yan Liu Haifeng Jiang Haifeng Jiang Jiang Du Yan Zhao Zheyi Du Shuo Li Haihong Wang A Case Report of Excessive Use of Clozapine Combined With Clonazepam Frontiers in Psychiatry schizophrenia clozapine clonazepam therapeutic drug monitoring (TDM) withdrawal case report |
| title | A Case Report of Excessive Use of Clozapine Combined With Clonazepam |
| title_full | A Case Report of Excessive Use of Clozapine Combined With Clonazepam |
| title_fullStr | A Case Report of Excessive Use of Clozapine Combined With Clonazepam |
| title_full_unstemmed | A Case Report of Excessive Use of Clozapine Combined With Clonazepam |
| title_short | A Case Report of Excessive Use of Clozapine Combined With Clonazepam |
| title_sort | case report of excessive use of clozapine combined with clonazepam |
| topic | schizophrenia clozapine clonazepam therapeutic drug monitoring (TDM) withdrawal case report |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.831276/full |
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