Abstract
Clozapine is a very important atypical antipsychotic indicated for one to two third patients of resistant psychotic symptoms. It is also indicated in Treatment Resistant Bipolar Disorder (TRBD), Tardive Dyskinesia (TD) and few other indications. Most common side effects of clozapine are hypersalivation, sedation, constipation, hypertension, hypotension, fever, seizure, tachycardia, nocturnal enuresis and agranulocytosis. The study aimed to look into the patients getting clozapine in respect of demography, disease and side effects profile. This cross sectional study was conducted among 21 hospitalised patients those getting clozapine. The data were collected with semi structured questionnaire and preformed checklist through face to face interview, physical examination and available laboratory investigations. Majority of the patients were male and Resistant Schizophrenia was most common diagnosis. The effective therapeutic dose was 50-200 mg/day in most cases (64%). Sedation (90.5%), hyper salivation (81%), constipation (81%), nausea (23.8%), nocturnal enuresis (23.8%), hypertension (9.5%), and tachycardia (28.6%) were the noted side effects. Among the developed side effects constipation and sedation occurred at lower dosage. Though the study sample is small, observed set of side effects are similar and coherent with existing evidences. Further broad based study needed to extract representative data that can be utilised in future clinical practice locally.
Highlights
Bangladesh is one of the densely populated developing countries with about 160 million people [1]
Though the debate regarding efficacy of FGA and SGA is still ongoing, clozapine is choice of drug in Treatment Resistant Schizophrenia (TRS). It is effective in Treatment Resistant Bipolar Disorder (TRBD), Tardive Dyskinesia (TD) [3, 4]
Clozapine therapy was given among the patients of TRS, TRBD and TD which is aligned with the evidence based psychiatric practice [3, 6, 24]
Summary
Bangladesh is one of the densely populated developing countries with about 160 million people [1]. Though the debate regarding efficacy of FGA and SGA is still ongoing, clozapine is choice of drug in Treatment Resistant Schizophrenia (TRS). It is effective in Treatment Resistant Bipolar Disorder (TRBD), Tardive Dyskinesia (TD) [3, 4]. The common adverse effects of clozapine are sedation, hypersalivation, constipation, hypotension, hypertension, tachycardia, weight gain, fever, seizure, nocturnal enuresis, neutropenia/agranulocytosis, gastroesophageal reflux disease (GERD) [6,7,8,9,10,11,12]. Authors intended to observe pattern of distribution of diagnoses and the side effects profile of patients getting clozapine in a country like Bangladesh where there is still no national guidelines
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