Nghiên cứu đặc điểm lâm sàng bệnh tâm thần phân liệt đáp ứng kém với thuốc an thần kinh cổ điển và kết quả điều trị bằng thuốc clozapine tt tiếng anh

MINISTRY OF EDUCATION MINISTRY OF DEFENSE AND TRAINING MILITARY MEDICAL UNIVERSITY PHUNG THANH HAI STUDY ON CLINICAL FEATURES OF SCHIZOPHRENIC PATIENTS, WHO RESPOND POORLY TO CLASSIC ANTIPSHYCHOTIC DRUGS Specialism: Neuroscience Code: 9720159 SUMMARY OF MEDICAL DOCTORAL THESIS HANOI - 2019 THE WORK HAS BEEN SUCCESSFULLY COMPLETED AT MILITARY MEDICAL UNIVERSITY – MINISTRY OF DEFENSE Science Supervisors: Prof PhD Cao Tien Duc Associate Prof PhD Bui Quang Huy Opponent 1: Associate Prof PhD Opponent 2: Associate Prof PhD Opponent 3: Associate Prof PhD The thesis will be protected before the doctoral thesis review Broad in Military Medical University – Ministry of Defense By date month 2019 This thesis can be found at the library: Military Medical University library – Ministry of Defense National library of Vietnam BACKGROUND I The urgency of the project: Schizophrenia is a clinical syndrome of variable, but profoundly disruptive, psychopathology that involves cognition, emotion, perception, and other aspects of behavior The expression of these manifestations varies across patients and over time, but the effect of the illness is always severe and is usually long lasting The disorder usually begins before age 25, persists throughout life, and affects persons of all social classes In the United States, the lifetime prevalence of schizophrenia is about percent, and in Vietnam, it is 0.47% of the population Classic neuroleptics are often used for treatment According to Kaplan H.I et al (1994), about 60 - 70% of schizophrenia patients respond well to classic neuroleptics and the remaining 30-40% of these patients make a poor response The classic neuroleptiques and should be replaced by atypical neuroleptiques such as Risperidone, Olanzapine, but Clozapine is the most effective Stephen M.S (2003) stated that we have to quantify blood levels of the drug in order to have a proper drug regulation Bui Tien Dung (2011) studied Clozapine treatment for chronic schizophrenia but the results were limited and no research has been done about the response to poor treatment with classic neuroleptics and the determination of the plasma concentration of Clozapine to assess the effectiveness of treatment II The aim of the thesis: Review clinical features of schizophrenia in patients who respond poorly to classic neuroleptiques 2 Evaluate results of treatment by clozapine for schizophrenic patients, who respond poorly to classic neuroleptiques, under the PANSS scale Comment on the relationship between plasma levels of clozapine and treatment results of schizophrenic patients, who respond poorly to classical neuroleptique, under the PANSS scale III Practical significance and new contributions of the project: - The average age of schizophrenia patients is 32.08 ± 8.91 years The average duration of schizophrenia is 23.64 ± 6.32 years; The average age of onset is 23.64 ± 6.32 years and the number of relapses is 23.64 ± 6.32 years - Clinical symptoms of schizophrenia, which respond poorly to Haloperidol: 60.66% are paranoid type; social withdrawal (78.69%); diminished emotional range (62.29%); emotional blunting (54.10%); poverty of speech (52.46%); slow thinking (91.80%); poor personal hygiene, withdrawal from work-related situations, diminished sense of purpose, diminished social drive (100%) - The treatment of schizophrenic patients with clozapine under the PANSS scale through T4, T6 and T8 was very statistically significant with p