{"title":"Methylphenidate as Treatment for Clozapine-Induced Sedation in Patients with Treatment-Resistant Schizophrenia.","authors":"David Sarfati, Jonathan Lai, Howard C Margolese","doi":"10.3371/CSRP.SALA.061518","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Treatment-resistant schizophrenia patients frequently need to be managed with clozapine. However, noncompliance is in-part due to complaints of sedation, fatigue, and low energy. There is little literature reporting on the effectiveness and safety of using stimulants to treat clozapine-induced sedation. We report three cases of treatment-resistant schizophrenia where methylphenidate was used to address these common side-effects.</p><p><strong>Methods: </strong>To evaluate the effectiveness and safety of psychostimulants in treatment-resistant schizophrenia, we reviewed 3 extensively documented cases of clozapine-induced sedation treated with methylphenidate for over 2 years, in addition to reviewing the literature on this topic.</p><p><strong>Results: </strong>All 3 patients reported improvements in energy and fatigue, along with decreased sedation, while treated with methylphenidate for 27, 30, and 32 months respectively. Clozapine doses ranged between 325mg and 500mg daily; methylphenidate doses ranged between 2.5mg of the immediate-release and 72mg daily of the extended-release formulation. There was no reported or observed increase in psychotic symptoms resulting from treatment with methylphenidate.</p><p><strong>Conclusion: </strong>Methylphenidate may be safe and effective in the management of clozapine-induced sedation in treatment-resistant schizophrenia. Large scale, placebo-controlled, double-blind trials are needed to further validate the safety and efficacy of methylphenidate as treatment for clozapine-induced sedation.</p>","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2018-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Schizophrenia and Related Psychoses","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3371/CSRP.SALA.061518","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Treatment-resistant schizophrenia patients frequently need to be managed with clozapine. However, noncompliance is in-part due to complaints of sedation, fatigue, and low energy. There is little literature reporting on the effectiveness and safety of using stimulants to treat clozapine-induced sedation. We report three cases of treatment-resistant schizophrenia where methylphenidate was used to address these common side-effects.
Methods: To evaluate the effectiveness and safety of psychostimulants in treatment-resistant schizophrenia, we reviewed 3 extensively documented cases of clozapine-induced sedation treated with methylphenidate for over 2 years, in addition to reviewing the literature on this topic.
Results: All 3 patients reported improvements in energy and fatigue, along with decreased sedation, while treated with methylphenidate for 27, 30, and 32 months respectively. Clozapine doses ranged between 325mg and 500mg daily; methylphenidate doses ranged between 2.5mg of the immediate-release and 72mg daily of the extended-release formulation. There was no reported or observed increase in psychotic symptoms resulting from treatment with methylphenidate.
Conclusion: Methylphenidate may be safe and effective in the management of clozapine-induced sedation in treatment-resistant schizophrenia. Large scale, placebo-controlled, double-blind trials are needed to further validate the safety and efficacy of methylphenidate as treatment for clozapine-induced sedation.
期刊介绍：
The vision of the exciting new peer-reviewed quarterly publication Clinical Schizophrenia & Related Psychoses (CS) is to provide psychiatrists and other healthcare professionals with the latest research and advances in the diagnosis and treatment of schizophrenia and related psychoses. CS is a practice-oriented publication focused exclusively on the newest research findings, guidelines, treatment protocols, and clinical trials relevant to patient care.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
