Year: 2019
Type: dissertation
Study design: Observational Study
Abstract: Clozapine is the main treatment for patients with significant psychotic symptoms despite adequate trials of non-clozapine antipsychotics. However, 40-70% of patients show suboptimal response to clozapine. We aimed to: (1) examine the relationship between delay in initiating clozapine and treatment outcomes through a literature review; (2) examine clozapine response/non-response trajectories and predictors of long-term non-response through a retrospective chart review; and (3) determine the relationships between glutamatergic neurometabolites and cortical thickness through a cross-sectional imaging study. Delay in initiating clozapine and number of hospitalizations were associated with poor clozapine response. Further, response trajectories ranged from sustained response or non-response to developed response or non-response. Finally, glutamatergic neurometabolite levels in the dorsal anterior cingulate cortex were associated with cortical thinning in the right prefrontal cortex in patients with treatment-resistant schizophrenia, independent of age, sex, treatment, and illness severity. This work advances our understanding of treatment-resistant schizophrenia from clinical and neuropathological perspectives.
Source: TSpace (University of Toronto)
Author: Parita Shah
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3150871229