The effects of antipsychotic drugs on depression level in patients with schizophrenia: clozapine vs. other atypical antipsychotics
Abstract
Introduction: Depressive symptoms may occur in all stages of schizophrenia disorder. Clozapine is the only antipsychotic that has been demonstrated superior efficacy in schizophrenia and suicidal ideation. The aim of this study is to evaluate depressive symptoms in patients with schizophrenia treated with clozapine and to compare with treated with other atypical antipsychotics.
Methods: A cross-sectional descriptive study was carried out on patients with schizophrenia according to DSM-IV-TR between December 2012 and May 2013. All participants were evaluated for demographic characteristics and points of Brief Psychiatric Rating Scale, Positive, Negative Syndrome Scale, and Calgary Depression Scale for Schizophrenia.
Results: A total 23.6% (n = 13) patients treated with clozapine, while 76.4% (n = 42) patients were treated with other antipsychotic drugs. 23.1% (n = 3) of patients taking clozapine were women, 76.9% (n = 10) were male. The mean age of patients treated with clozapine was 43.0 ± 11.2. The level of depression of patients treated with clozapine was 15.4% (n = 2). No statistically significant difference was found between patients between treated with clozapine and other antipsychotics regarding age, sex, marital status, education years, work history, age at onset of disease, depression and history of suicide attempt
Conclusion: As a result of this study it is found that clozapine did not effect on the level of depression in patients with schizophrenia, and depression level of patients with schizophrenia treated with clozapine had no difference from patients treated with other antipsychotics.
References
- Siris S. Diagnosis of secondary depression in schizophrenia: implications for DSM-IV. Schizophr Bull 1991;17:75-98.
- Zisook S, McAdams LA, Kuck J, et al. Depressive symptoms in schizophrenia. Am J Psychiatry 1999; 56:1736-1743.
- Schennach-Wolff R, Obermeier M, Seemüller F, et al. Evaluating depressive symptoms and their impact on outcome in schizophrenia applying the Calgary Depression Scale. Acta Psychiatr Scand 2011;123:228-238.
- Siris SG. Suicide and schizophrenia. J Psychopharmacol. 2001;15(2):127–135.
- Leucht S, Cipriani A, Spineli L, et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet. 2013;382(9896):951–962.
- Breier AF, Malhotra AK, Su TP, et al. Clozapine and Risperidone in chronic schizophrenia: effects on symptoms, parkinsonian side effects, and neuroendocrine response. Am J Psychiatry. 1999;156(2):294–298.
- Azorin JM, Spiegel R, Remington G, et al. A double-blind comparative study of clozapine and Risperidone in the management of severe chronic schizophrenia. Am J Psychiatry. 2001;158(8):1305–1313.
- Lindenmayer JP, Czobor P, Volavka J, et al. Effects of atypical antipsychotics on the syndromal profile in treatment resistant schizophrenia. J Clin Psychiatry. 2004;65(4):551–556.
- Lewis SW, Barnes TR, Davies L, et al. Randomized controlled trial of effect of prescription of clozapine versus other second generation antipsychotic drugs in resistant schizophrenia. Schizophr Bull. 2006;32(4):715–723.
- Aydemir Ö, Esen Danacı A, Deveci A, İçelli İ. Calgary şizofrenide depresyon ölçeği’nin Türkçe versiyonunun güvenilirliği ve geçerliliği. Nöropsikiyatri Arşivi 2000;37:82-86.
- Nakajima S, Takeuchi H, Fervaha G, et al. Comparative efficacy between clozapine and other atypical antipsychotics on depressive symptoms in patients with schizophrenia: analysis of the CATIE phase 2E data. Schizophr Res. 2015 Feb;161(2-3):429-33.
Şizofreni hastalarında antipsikotiklerin depresyon düzeyine etkisi: klozapine karşı diğer atipik antipsikotikler
Abstract
Giriş: Depresif belirtiler şizofreninin hemen tüm evrelerinde görülmektedir. Şizofreni tedavisinde kullanılan antipsikotik ilaçlar arasında tedaviye dirençli şizofrenide en etkili antipsikotik olan klozapin’in bu hasta grubunda intihar riskini azalttığı bilinmektedir. Bu çalışmanın amacı klozapin kullanan şizofreni hastalarında depresyon düzeyini saptamak, diğer atipik antipsikotik ilaçları kullanan hastalarla karşılaştırmaktır.
Yöntem: Bu çalışma Aralık 2012-Mayıs 2013 tarihleri arasında DSM-IV-TR’ye göre şizofreni tanılı hastaların değerlendirildiği kesitsel-tanımlayıcı bir çalışmadır. Tüm katılımcıların demografik özellikleri ve Kısa Psikiyatrik Değerlendirme Ölçeği (KPDÖ), Pozitif ve Negatif Sendrom Ölçeği (PNSÖ) ve Calgary Şizofrenide Depresyon Ölçeği (CŞDÖ) puanları değerlendirildi.
Bulgular: Hastaların %23,6’sı (n = 13) klozapin, %76,4’ü (n = 42) diğer antipsikotikleri kullandığı tespit edildi. Klozapin kullanan hastaların %23,1’i (n = 3) kadın, %76,9‘u (n=10) erkekti. Klozapin kullanan hastaların yaş ortalaması 43,0 ± 11,2 idi. Klozapin kullanan hastaların depresyon düzeyi %15,4(n = 2) olarak bulundu. Klozapin kullanan ve kullanmayan hastaların yaş, cinsiyet, medeni durum, eğitim süreleri, hastalık başlangıç yaşı, depresyon varlığı, intihar girişimi öyküsü değerlendirildiğinde her iki grup arasında istatistiksel olarak anlamlı fark saptanmadı.
Sonuç: Şizofreni hastalarında klozapin kullanımının depresyon düzeylerini etkilemediği ve diğer antipsikotikler ile kıyaslandığında depresyon üzerinde farklı bir etkileri olmadığı tespit edilmiştir.
Keywords
References
- Siris S. Diagnosis of secondary depression in schizophrenia: implications for DSM-IV. Schizophr Bull 1991;17:75-98.
- Zisook S, McAdams LA, Kuck J, et al. Depressive symptoms in schizophrenia. Am J Psychiatry 1999; 56:1736-1743.
- Schennach-Wolff R, Obermeier M, Seemüller F, et al. Evaluating depressive symptoms and their impact on outcome in schizophrenia applying the Calgary Depression Scale. Acta Psychiatr Scand 2011;123:228-238.
- Siris SG. Suicide and schizophrenia. J Psychopharmacol. 2001;15(2):127–135.
- Leucht S, Cipriani A, Spineli L, et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet. 2013;382(9896):951–962.
- Breier AF, Malhotra AK, Su TP, et al. Clozapine and Risperidone in chronic schizophrenia: effects on symptoms, parkinsonian side effects, and neuroendocrine response. Am J Psychiatry. 1999;156(2):294–298.
- Azorin JM, Spiegel R, Remington G, et al. A double-blind comparative study of clozapine and Risperidone in the management of severe chronic schizophrenia. Am J Psychiatry. 2001;158(8):1305–1313.
- Lindenmayer JP, Czobor P, Volavka J, et al. Effects of atypical antipsychotics on the syndromal profile in treatment resistant schizophrenia. J Clin Psychiatry. 2004;65(4):551–556.
- Lewis SW, Barnes TR, Davies L, et al. Randomized controlled trial of effect of prescription of clozapine versus other second generation antipsychotic drugs in resistant schizophrenia. Schizophr Bull. 2006;32(4):715–723.
- Aydemir Ö, Esen Danacı A, Deveci A, İçelli İ. Calgary şizofrenide depresyon ölçeği’nin Türkçe versiyonunun güvenilirliği ve geçerliliği. Nöropsikiyatri Arşivi 2000;37:82-86.
- Nakajima S, Takeuchi H, Fervaha G, et al. Comparative efficacy between clozapine and other atypical antipsychotics on depressive symptoms in patients with schizophrenia: analysis of the CATIE phase 2E data. Schizophr Res. 2015 Feb;161(2-3):429-33.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research |
| Authors | |
| Publication Date | August 30, 2016 |
| Submission Date | March 11, 2016 |
| Acceptance Date | June 2, 2016 |
| Published in Issue | Year 2016Volume: 1 Issue: 2 |
