In:
Pharmacopsychiatry, Georg Thieme Verlag KG, Vol. 53, No. 06 ( 2020-11), p. 273-283
Abstract:
Background Even though clozapine is the recommended last-resort
antipsychotic, many patients fail to respond and show treatment-refractory psychotic symptoms. Smoking has been suggested as a possible risk factor for
poor clozapine response, hampering remission and negatively impacting somatic outcomes. Methods Our aim was to test whether smoking status is associated with
remission rates and other symptomatic and somatic outcomes. We therefore assessed remission rates according to The Remission in Schizophrenia Working
Group (RSWG) criteria, and metabolic and cognitive outcomes among patients with schizophrenia-spectrum disorders treated with clozapine for at least 6
months. For analyses, we grouped our cohort into 3 groups according to clozapine treatment duration (6 months, 2 years, 5 years). Results One hundred five patients were included in our analyses and
grouped according to their clozapine treatment duration. In the 6-months analyses, patients who smoked were significantly more likely to be younger
of age (p=0.002) despite on average shorter duration of clozapine treatment (p=0.041) and significantly more likely to be treated with
mood-stabilizing co-medication (p=0.030) compared to nonsmokers. Remission rates (p=0.490), as well as a set of metabolic and
cognitive variables did not differ between the 2 groups. A related pattern could be observed for the 2- and 5-years analyses. Conclusions Smoking behavior among clozapine-treated schizophrenia
patients might delineate a cohort with an earlier onset of the disease. Nevertheless, most findings comparing disease-specific and clinical outcomes
among smokers and nonsmokers were negative. Further research is needed to identify strategies to overcome insufficient remission rates in this patient
group.
Type of Medium:
Online Resource
ISSN:
0176-3679
,
1439-0795
Language:
English
Publisher:
Georg Thieme Verlag KG
Publication Date:
2020
detail.hit.zdb_id:
2041961-2
SSG:
15,3
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