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| Clinical Efficacy and Safety of Individualized Dose Optimization of Clozapine in the Treatment of Refractory Schizophrenia |
| LI Gongquan, CAO Linjia, XIE Qingfang |
| Baoshan District Mental Health Center, Shanghai 201906 |
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Abstract 【Objective】To explore the clinical efficacy and safety of individualized dose optimization of clozapine in the treatment of refractory schizophrenia. 【Methods】 A total of 136 patients with refractory schizophrenia admitted to Baoshan District Mental Health Center in Shanghai from November 2022 to June 2024 were selected. The patients were randomly divided into the observation group and the control group using a random number table method, with 68 patients in each group. The observation group was treated with adjusted dosage based on the patient's clinical response and drug concentration, while the control group was treated according to the dosage standard specified in the drug instructions. Both groups were treated for 3 months, then the positive and negative symptom scale (PANSS) scores and adverse reactions were compared between the two groups. The blood drug concentration of chlorpromazine was also compared between the two groups of patients. 【Results】 The PANSS scores of the observation group at 1 month, 2 months, and 3 months of treatment were lower than those of the control group, and the difference was statistically significant (P<0.05). The blood drug concentrations of the observation group at 1 month, 2 months, and 3 months of treatment was higher than those of the control group, and the difference was statistically significant (P<0.05). The incidence of adverse reactions in the observation group was 10.29% (7/68), which was significantly lower than the 25.00% (17/68) in the control group, and the difference was statistically significant (χ2=5.060, P<0.05). One patient in the observation group developed leukopenia, which returned to normal after adjusting the dosage. Two patients in the control group showed leukopenia, and one patient needed to adjust the treatment plan. Both groups had one patient with electrocardiogram changes, but most of them were mild changes that did not lead to serious complications. 【Conclusion】 Individualized dose optimization of chlorpromazine in the treatment of refractory schizophrenia can improve clinical treatment efficacy. By adjusting the dose individually, the incidence of adverse reactions can be reduced while ensuring efficacy.
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Received: 09 December 2024
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2025, Vol. 42 
