Safety and efficacy of combined clozapine–lithium pharmacotherapy

  • Several case reports described neurotoxic side-effects in the course of a combined clozapine-lithium treatment. Here we report on the safety and efficacy of this combination in a sample of 44 hospital patients. Medical records were retrospectively audited and a subsample of 23 patients was re-assessed. Mean total duration of combined treatment was 23.5 months. The combination (indications: prophylaxis; treatment of affective symptoms or aggression/excitement; augmentation of neuroleptic efficacy) was rated effective in 84% and adverse events were reported in 64% of the patients. Notably, most of the adverse events were benign and transient. However, 8 patients (18%) developed transient neurological adverse events that were genuinely novel in only 3 patients (7%) and coincided with high dosage of medication or high plasma levels or serotonergic (antidepressant) co-medication. Our data suggest that combined clozapine-lithium treatment may appear to be safe and effective when administered within a moderate therapeutic dose range andSeveral case reports described neurotoxic side-effects in the course of a combined clozapine-lithium treatment. Here we report on the safety and efficacy of this combination in a sample of 44 hospital patients. Medical records were retrospectively audited and a subsample of 23 patients was re-assessed. Mean total duration of combined treatment was 23.5 months. The combination (indications: prophylaxis; treatment of affective symptoms or aggression/excitement; augmentation of neuroleptic efficacy) was rated effective in 84% and adverse events were reported in 64% of the patients. Notably, most of the adverse events were benign and transient. However, 8 patients (18%) developed transient neurological adverse events that were genuinely novel in only 3 patients (7%) and coincided with high dosage of medication or high plasma levels or serotonergic (antidepressant) co-medication. Our data suggest that combined clozapine-lithium treatment may appear to be safe and effective when administered within a moderate therapeutic dose range and without serotonergic co-medication or other substances interfering with clozapine metabolism.show moreshow less

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Metadaten
Institutes:Fakultät Humanwissenschaften / Professur für Pathopsychologie
Author:Stefan Bender, Thomas Linka, Jörg Wolstein, Susanne Gehendges, Hermann-Josef Paulus, Ulrich Schall, Markus Gastpar
Title of the journal / compilation (English):The international journal of neuropsychopharmacology : official scientific journal of the Collegium Internationale Neuro-Psychopharmacologicum (CINP)
Place of publication:Cambridge
Publisher:Univ. Press
Year of publication:2004
Issue:7 (2004), 1
Pages / Size:Seite 59-63
DOI:https://doi.org/10.1017/S1461145703003870
ISSN:1461-1457
Document Type:Article in a journal
Language:English
Release Date:2018/11/09