[저자] Elias Wagner, Dan Siskind, Peter Falkai, Oliver Howes, Christoph Correll, Jimmy Lee, William G Honer, John M Kane, Emilio Fernandez-Egea, Thomas R E Barnes, Alkomiet Hasan,
TRRIP Working Group
AgidOferArangoCelsoBaandrupLoneBarnesThomas R Ede BartolomeisAndreavan BeverenNico J MBirnbaumMichael LBitterIstvánBreierAlainBuchananRobert WCarpenterWilliam TCastleDavid JChenEricCitromeLeslieCotterDavidCorrellChristoph UCrespo-FacorroBenedictoDavidsonMichaelDrakeRichard JDollfusSoniaDursunSerdarEbdrupBjørn HEmsleyRobinFernandez-EgeaEmilioElkisHelioFalkaiPeterFleischhackerWolfgangFreudenreichOliverGadelhaAryGaebelWolfgangGlenthøjBirte YGoffDonald CGraff-GuerreroArielHallakJaime E CHasanAlkomietHonerWilliam GHomanPhilipHowesOliverKahnRene SKaiserStefanKaneJohnKennedyJamesKinonBruceKimEuitaeLawrieStephen MLeeJimmyLeuchtStefanLewekeMarkusLibigerJanLoebelAntonyMacCabeJames HMarderStephen RMcCutcheonRobMelleIngridMeltzerHerbertMucciArmidaNaberDieterNakajimaShinchiroNielsenJimmiO’BrienOisinOjagbemiAkinPantelisChristosPeuskensJosephPotkinSteveMarquesTiago ReisRaedlerThomasRemingtonGaryRossellSusan LRubio-LorenteJoseSachsGabrieleSiskindDanSiuCynthia OSommerIris EKwonJun SooSuzukiTakefumiSuvisaariJaanaTakeuchiHiroyoshiTandonRajivTaylorDavidThomasNeilTiihonenJariUchidaHiroyukiÜçokAlpUmbrichtDanielVenkatasubramanianGanesanWagnerEliasWaltersJames T RWangChuan-YueWeillerEmmanuelleWeiserMark
, Ofer Agid, Celso Arango, Lone Baandrup, Thomas R E Barnes, Andrea de Bartolomeis, Nico J M van Beveren, Michael L Birnbaum, István Bitter, Alain Breier, Robert W Buchanan, William T Carpenter, David J Castle, Eric Chen, Leslie Citrome, David Cotter, Christoph U Correll, Benedicto Crespo-Facorro, Michael Davidson, Richard J Drake, Sonia Dollfus, Serdar Dursun, Bjørn H Ebdrup, Robin Emsley, Emilio Fernandez-Egea, Helio Elkis, Peter Falkai, Wolfgang Fleischhacker, Oliver Freudenreich, Ary Gadelha, Wolfgang Gaebel, Birte Y Glenthøj, Donald C Goff, Ariel Graff-Guerrero, Jaime E C Hallak, Alkomiet Hasan, William G Honer, Philip Homan, Oliver Howes, Rene S Kahn, Stefan Kaiser, John Kane, James Kennedy, Bruce Kinon, Euitae Kim, Stephen M Lawrie, Jimmy Lee, Stefan Leucht, Markus Leweke, Jan Libiger, Antony Loebel, James H MacCabe, Stephen R Marder, Rob McCutcheon, Ingrid Melle, Herbert Meltzer, Armida Mucci, Dieter Naber, Shinchiro Nakajima, Jimmi Nielsen, Oisin O’Brien, Akin Ojagbemi, Christos Pantelis, Joseph Peuskens, Steve Potkin, Tiago Reis Marques, Thomas Raedler, Gary Remington, Susan L Rossell, Jose Rubio-Lorente, Gabriele Sachs, Dan Siskind, Cynthia O Siu, Iris E Sommer, Jun Soo Kwon, Takefumi Suzuki, Jaana Suvisaari, Hiroyoshi Takeuchi, Rajiv Tandon, David Taylor, Neil Thomas, Jari Tiihonen, Hiroyuki Uchida, Alp Üçok, Daniel Umbricht, Ganesan Venkatasubramanian, Elias Wagner, James T R Walters, Chuan-Yue Wang, Emmanuelle Weiller, Mark Weiser
[Category] update2024,
[Article Type] Regular Article
[Source] PMC
Abstract Background and Hypothesis There is limited evidence to guide the approaches to clozapine treatment. Accordingly, an international initiative was undertaken with the aim of developing consensus recommendations for the optimization of clozapine monotherapy. Study Design We conducted an online Delphi survey among members of the Treatment Response and Resistance in Psychosis (TRRIP) working group comprising experts from twenty-nine countries. The threshold criterion for a consensus recommendation was ≥ 75% agreement (“agree” and “strongly agree” responses) on a question. Agreement of ≥ 50% but < 75% in a second or third Delphi round was deemed to provide guidance. Study Results Forty-nine (first round), 32 (second round), and 48 (third round) of the 91 current TRRIP members participated. Expert recommendations at ≥ 75% comprised second-line treatment with clozapine in cases of persistent positive symptoms with co-occurring extrapyramidal symptoms, tardive dyskinesia, or suicidality/aggression. There was considerable disagreement on myocarditis screening parameters. The management of somatic and neuropsychiatric adverse drug reactions warrants further research for more evidence-based recommendations. Rechallenge with clozapine was recommended for eosinophilia, sinus tachycardia and fever and guidance (agreement ≥ 50%) was reached for pneumonia and thrombocytopenia. Conclusions Given the limited evidence available, this consensus-based series of recommendations and guidance statements supports clinical decision-making to optimize clozapine monotherapy and provides guidance for future research in treatment-resistant schizophrenia.
All Keywords
【저자키워드】 Schizophrenia, DelPhi, clozapine, Consensus,