Yuta Kawakita1,2, Masahiro Takeshima3, Tomonari Komatsu4, Aya Imanishi3, Dai Fujiwara3, Yu Itoh3, Kazuo Mishima3. 1. Department of Neuropsychiatry, Akita City Hospital, 4-30 Kawamoto Matsuokamachi, Akita City, 010-0933, Japan. yutakawakita2020@gmail.com. 2. Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan. yutakawakita2020@gmail.com. 3. Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan. 4. Department of Neuropsychiatry, Noshiro Kousei Medical Center, Akita, Japan.
Abstract
OBJECTIVE: Clozapine may cause serious side effects despite benefits in patients with schizophrenia. Thus, an accurate understanding of the side-effect profile of clozapine is extremely important in the management of its administration to patients with schizophrenia. Our aim was to validate the relationship between clozapine exposure and appendicitis onset in patients with schizophrenia. METHODS: In this study, we retrospectively compared the incidence and cumulative incidence of appendicitis in patients with schizophrenia with and without a history of clozapine exposure. Among the patients with schizophrenia who visited our hospital between June 2009 and August 2021, we extracted those with a history of clozapine treatment. Patients with a history of taking clozapine were defined as the clozapine exposure group, while the others were defined as the clozapine non-exposure group. Patients with a history of appendectomy before their initial visit to our hospital or with a history of clozapine use at other hospitals were excluded. RESULTS: There were 65 patients in the clozapine exposure group and 400 patients in the clozapine non-exposure group who met the inclusion criteria. The exposure group exhibited a remarkably higher incidence of appendicitis during the observation period than the non-exposure group (863 cases vs. 124 cases per 100,000 person-years). In particular, if limited to the period of clozapine exposure, the incidence of appendicitis is extremely high, at 2,086 cases per 100,000 person-years. Moreover, multivariable analysis showed that clozapine exposure was an independent factor contributing to the onset of appendicitis. CONCLUSIONS: Clozapine exposure is associated with appendicitis onset in patients with schizophrenia.
OBJECTIVE: Clozapine may cause serious side effects despite benefits in patients with schizophrenia. Thus, an accurate understanding of the side-effect profile of clozapine is extremely important in the management of its administration to patients with schizophrenia. Our aim was to validate the relationship between clozapine exposure and appendicitis onset in patients with schizophrenia. METHODS: In this study, we retrospectively compared the incidence and cumulative incidence of appendicitis in patients with schizophrenia with and without a history of clozapine exposure. Among the patients with schizophrenia who visited our hospital between June 2009 and August 2021, we extracted those with a history of clozapine treatment. Patients with a history of taking clozapine were defined as the clozapine exposure group, while the others were defined as the clozapine non-exposure group. Patients with a history of appendectomy before their initial visit to our hospital or with a history of clozapine use at other hospitals were excluded. RESULTS: There were 65 patients in the clozapine exposure group and 400 patients in the clozapine non-exposure group who met the inclusion criteria. The exposure group exhibited a remarkably higher incidence of appendicitis during the observation period than the non-exposure group (863 cases vs. 124 cases per 100,000 person-years). In particular, if limited to the period of clozapine exposure, the incidence of appendicitis is extremely high, at 2,086 cases per 100,000 person-years. Moreover, multivariable analysis showed that clozapine exposure was an independent factor contributing to the onset of appendicitis. CONCLUSIONS: Clozapine exposure is associated with appendicitis onset in patients with schizophrenia.
Authors: Anthony F Lehman; Jeffrey A Lieberman; Lisa B Dixon; Thomas H McGlashan; Alexander L Miller; Diana O Perkins; Julie Kreyenbuhl Journal: Am J Psychiatry Date: 2004-02 Impact factor: 18.112
Authors: John M Kane; Ofer Agid; Marjorie L Baldwin; Oliver Howes; Jean-Pierre Lindenmayer; Stephen Marder; Mark Olfson; Steven G Potkin; Christoph U Correll Journal: J Clin Psychiatry Date: 2019-03-05 Impact factor: 4.384