SU114. Switching to Clozapine Treatment in Patients With Schizophrenia: The Clinical Course, Remission, and Augmentation of Treatment After the Switch
Bibliographic record
Abstract
Background: This study aims to compare clinical features of schizophrenia patients before and after clozapine initiation and to investigate the clinical course of illness, clinical features, remission state, and augmentation methods under clozapine treatment. Methods: A total of 122 consecutive outpatients diagnosed with DSM-IV criteria for schizophrenia and receiving clozapine treatment were included. Patients were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders, Positive and Negative Syndrome Scale, Clinical Global Impression Scale, Global Assessment of Functioning, Calgary Depression Scale for Schizophrenia, Panic Agoraphobia Scale, Yale-Brown Obsessive Compulsive Scale, and the World Health Organization Disability Assessment Schedule-2.0 to determine the severity of psychopathology and comorbid symptoms, as well as the level of functioning and disability. The remission state of the patients was assessed utilizing the Schizophrenia Working Group’s remission criteria for schizophrenia. Results: The number of psychotic relapses, hospitalizations, and suicide attempts along with alcohol-drug misuse rates declined after the initiation of clozapine. The study group consisted of schizophrenia patients using clozapine for a mean period of 9 years, and 44.5% of these patients were found to be in a symptomatic remission state. No relationship was shown between remission state and clozapine dose/plasma levels. Education level was found to be higher, work status better, and comorbid symptom severity lower in remitted patients. There was no difference between remitted and not remitted patients in terms of the duration of clozapine use and age at disease onset. Education level, positive and negative symptom severity predicted achievement of remission on clozapine. The augmentation strategies were examined in patients showing partial response to clozapine, and combined antipsychotic drug use was found to be the most prevalent method utilized. Patients on augmentation treatment were on higher daily clozapine doses and their remission rates were lower. In addition, the severity of psychopathology related with schizophrenia and comorbid symptoms, the level of functioning and disability were worse in this particular patient group. History of antipsychotic combination use prior to clozapine was found to predict the future use of clozapine augmentation. Conclusion: Shortening the duration of switch to clozapine and avoiding antipsychotic combinations prior to clozapine use should both be considered as important goals in the management of treatment resistant schizophrenia.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".