Outcomes of Clozapine Treatment in Ethiopia: A Retrospective Study
| dc.contributor.advisor | Dr.Getachew, Meron(M.D., Psychiatrist,AAU) | |
| dc.contributor.advisor | Dr.Girma, Engida(MD, Psychiatrist, AAU) | |
| dc.contributor.author | Kebede, Mekitew | |
| dc.date.accessioned | 2021-05-30T10:56:48Z | |
| dc.date.accessioned | 2023-11-05T09:32:58Z | |
| dc.date.available | 2021-05-30T10:56:48Z | |
| dc.date.available | 2023-11-05T09:32:58Z | |
| dc.date.issued | 2020-10 | |
| dc.description.abstract | Background:- Clozapine is a second-generation antipsychotic drug which was introduced in 1961. It has wide clinical utility particularly for patients with treatment-resistant schizophrenia. Prescription of clozapine shows a considerable variation across countries. There is a general delay in its initiation partly because of its adverse effects, unavailability of clozapine and psychiatrist attitudes towards the medication. Many studies have investigated clinical characteristics, adverse effect profile and treatment outcomes over time internationally. However, to the best of our knowledge, there is only one institution based study in Ethiopian. Objective: To assess the outcomes of clozapine treatment in five health facilities in Ethiopia. Method: A retrospective chart review was conducted from May to October, 2020 on patients who have been treated with clozapine between 2017 to 2020. Data extraction sheet was used to extract secondary data to assess indications, adverse effects and treatment outcomes of patients treated with clozapine . SPSS version 25 was used for data entry and analysis. Results: A total of 84 patients treated with clozapine were recruited and the main indications were treatment resistant schizophrenia(TRS) n=60 (71%), treatment resistant schizophrenia with tardive dyskinesia (TD) n=13(15.5%) and tardive dyskinesia n=10(11.9%). Seventy two (85.7%) patients had improvement of admission complaints upon discharge. The main improved symptoms were positive psychotic symptoms n=67(79.8%), negative symptoms n=52(61.9%), aggression n=33(39.3%), suicidal behavior n= 11(13.1%), depressive symptoms n=20(23.8%) and improvement of cognitive function n= 22(26. 2%). In case of TD patients, a mean AIMS score of 17.3 at admission reduced to 5.5 upon discharge. The most common side effects were sedation n=46(54.8%),sialorrhea n=31(36.9),constipation n=24(28.6%),weight gain n=18(21.4%) and transient hematological abnormalities n=14(16.7%). Serious side effect found were seizure n= 4(4.8%), persistent tachycardia n= 2(2.3%) and myocarditis n= 1(1.2%) Conclusion and Recommendation: Clozapine was indicated for treatment of TRS and TD, which resulted in improvement of admission complaints. Most of the side effects were tolerable and manageable. The main identified reason for discontinuation of the medication was unavailability. Having seen the indications, tolerable adverse effects and better treatment outcomes of clozapine, we recommend that patients with TRS and TD to be enrolled in clozapine treatment as soon as treatment-resistance is confirmed. | en_US |
| dc.identifier.uri | http://etd.aau.edu.et/handle/123456789/26596 | |
| dc.language.iso | en_US | en_US |
| dc.publisher | Addis Abeba University | en_US |
| dc.subject | Clozapine Treatment | en_US |
| dc.title | Outcomes of Clozapine Treatment in Ethiopia: A Retrospective Study | en_US |
| dc.type | Thesis | en_US |