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Yıl:2010; Cilt: 47; Sayı: 1>> Özet
TAM METİN
Nöropsikiyatri Arşivi; 2010;47(1):74-77
Klozapin Tedavisini Pimozid ile Güçlendirme Yaklaşımı: Tedaviye Dirençli Bir Şizofreni Olgusu
HA Akdağ, C Kısa, G Bekki, E Göka
Ankara Numune Hastanesi
Tedaviye dirençli şizofreni hastalarında monoterapide tercih edilen klozapin tedavisine % 40-70 oranında yeterli yanıt alınamamaktadır. Bu yüksek oranlarda bildirilen tedavi yanıtsızlığı klinisyenleri klozapini diğer farmakolojik ajanlarla güçlendirme yaklaşımlarına yönlendirmiştir. Bu amaçla yapılan çalışmalarda klozapin tipik ve atipik antipsikotikler, çeşitli antidepresanlar, duygu durum düzenleyiciler, bromokriptin ve glisin gibi ilaçlarla kombine edilmiştir. Ancak günümüze kadar yapılan çalışmaların sonuçları klozapin tedavisini güçlendirme yaklaşımlarını bilimsel anlamda desteklemek için henüz yeterli değildir. Klozapin tedavisini pimozid ile güçlendirme yaklaşımı nadiren de olsa literatürde tercih edilen bir tedavi olmuştur. Bu yazıda tedaviye dirençli dezorganize şizofreni tanısıyla takip edilen ve öyküsünde sadece klozapin ve pimozid kombinasyonundan fayda gören, ilaç kesilmesi sonrası psikotik belirtileri alevlenen ve tekrar bu kombinasyon başlandığında tedaviye belirgin iyi yanıt veren bir olguyu sunuyoruz.
Augmentation of Clozapine with Pimozide: A Case of a Treatment-Resistant Schizophrenic Patient
In the treatment of resistant schizophrenic patients, the preferred monotherapy of clozapine, does not result in sufficient treatment response in 40-70% of the cases. The high rate of treatment unresponsiveness has led clinicians to augment clozapine with other pharmacological agents. To date, many clinical and case studies have been conducted. In related studies, clozapine has been combined with various drugs, such as typical and atypical antipsychotics, several antidepressants, mood stabilizers, bromocriptine and glycine. However, up-to-date research study results are not sufficient to support the augmentation of clozapine therapy approaches. The augmentation of clozapine with pimozide has been a rarely preferred approach. In this paper, a case of a patient is presented, who was followed with the diagnosis of treatment-resistant disorganized schizophrenia and whose clozapine treatment was augmented with pimozide. The presented history reveals that only the combination of clozapine with pimozide was beneficial for this particular patient, whose symptoms relapsed after the cessation of the drugs, and who apparently benefited from treatment when this combination was initiated again.

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