Psychiatr. praxi. 2014;15(1):6-8

Treatment of hospitalized patients with schizophrenia

prof.MUDr.Eva Češková, CSc., MUDr.Michaela Mayerová

CEITEC-MU, Psychiatrická klinika LF MU a FN Brno

The most frequent reasons for hospitalization in patients suffering from schizophrenia are relapses and pharmacoresistancy. The main

cause of relapse is nonadherence which can be partially managed by depot antipsychotics. The gold standard of treatment in pharmacoresistant

patients is clozapine. In spite of this clozapine is initiated late in clinical practice and before initiating clozapine, antipsychotic

polypharmacy is very common. After the failure of clozapine monotherapy there are several possibilities including combination

of clozapine with other antipsychotics and clozapine augmentation. There are very few controlled studies supporting these strategies

with inconsistent results; therefore the pseudoresistance should be eliminated. The optimal possibility includes clozapine plasma levels

assessment. The results obtained at department of psychiatry in Brno show, that in patients non-responding to clozapine its plasma

levels are surprisingly often out of the therapeutic range. The clozapine plasma levels assessment in these problematic patients helps

to choose the further optimal treatment strategy.

Keywords: schizophrenia, relaps, pharmacoresistance, combinatins of antipsychotics, clozapine, plasma levels

Published: March 1, 2014  Show citation