Evidence map›Paper›PMID 36229076›Full record

ArticleBMJ case reports2022

Combination of strategies to initiate clozapine for refractory schizophrenia in a patient with low neutrophil levels.

Keisuke Takanobu, Naoki Hashimoto, Shuhei Ishikawa, Ichiro Kusumi

Open access · hybridAbstract readCase Reports
In one paragraph

Article in BMJ case reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.1field-weighted citation impact, top 50% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 1 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Keisuke TakanobuForensic Psychiatry Center, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
Naoki HashimotoDepartment of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan hashinao@med.hokudai.ac.jp.ORCID http://orcid.org/0000-0001-8311-7148
Shuhei IshikawaDepartment of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
Ichiro KusumiDepartment of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
Hokkaido University · JPHokkaido University Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Clozapine is the only drug with confirmed efficacy for refractory schizophrenia; however, its use is restricted due to the risk of potentially life-threatening side effects, such as agranulocytosis. Although this restriction ensures safety against haematological risks, some patients with refractory schizophrenia who have low neutrophil levels may miss the opportunity to receive clozapine treatment. We herein report the case of a patient with refractory schizophrenia and low neutrophil levels who was successfully initiated on clozapine treatment after the use of several methods for increasing neutrophil levels. These strategies consisted of discontinuation of antipsychotics, treatment with lithium carbonate and adenine, and light exercise before blood testing. Combining these procedures may be an effective option in the treatment of patients with refractory schizophrenia whose neutrophil levels are not sufficient to initiate clozapine.

Indexed as

Antipsychotic AgentsClozapineSchizophreniaAdenineHumansLithium CarbonateNeutrophilsSchizophrenia, Treatment-ResistantAdenineAntipsychotic AgentsClozapineLithium CarbonateDrugs: psychiatryHaematology (incl blood transfusion)Psychiatry (drugs and medicines)Schizophrenia

Identifiers

PMID36229076
PMCPMC9562318
OpenAlexW4306155245

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.