The assertive approach to clozapine: nasogastric administration

BJ Psych Bulletin

article

Alex Till¹  James Selwood²  Edward Silva³ 

[1] School of Psychiatry, Health Education North West (Mersey);School of Clinical Sciences, University of Bristol;Ashworth Hospital, Mersey Care NHS Foundation Trust

关键词: Psychotic disorders;    psychosis;    schizophrenia;    antipsychotics;    clozapine;    nasogastric administration.;   

DOI  :  10.1192/bjb.2018.61

学科分类：工程和技术（综合）

来源: Cambridge University Press

【 摘 要 】

Aims and method An ‘assertive approach’ to clozapine, where nasogastric administration is approved, is assessed through a case-load analysis to provide the first systematic description of its use and outcomes worldwide. Results Five of the most extremely ill patients with treatment-resistant schizophrenia were established and/or maintained on clozapine, resulting in improvements to their mental state; incidents were reduced, segregation was terminated and progression to less restrictive environments was achieved. Clinical implications Despite being underutilised and rarely enforced, in extreme circumstances, an assertive approach to clozapine can be justified. Nasogastric clozapine can be safely delivered and the approach itself, rather than actual nasogastric administration, may be enough to help establish and maintain patients with treatment-resistant schizophrenia on the most effective treatment. Declaration of interest E.S. has received speaker fees from Jansen Pharmaceuticals and Novartis.

【 授权许可】

CC BY