Abstract：
BACKGROUND: Seizures are considered to be one of the dreaded side effects of clozapine, and due to this, the use of clozapine is avoided in patients with treatment-resistant schizophrenia. Resultantly, there is little information about the use of clozapine among patients with seizure disorder.
OBJECTIVE: To assess the safety of clozapine in patients with history of seizures in their lifetime before starting clozapine and receiving clozapine for the management of psychotic disorders.
RESULTS: Out of the 958 patients, 35 (3.65 %) had a history of at least one seizure episode before starting clozapine, with a mean of 5.06 (SD: 7.23; Median: 3.00) seizures before starting clozapine. The mean duration between the last seizure and the starting of clozapine was 123.75 (SD: 124.99; Median: 84) months, with nine patients having an episode of seizure in the previous 12 months and 15 patients being seizure-free for more than ten years. About one-fourth (25.7 %; nine out of 35) of the patients had recurrence of seizure while receiving clozapine for a mean duration of about five years. When the recurrence of seizure after starting clozapine was evaluated in patients receiving antiepileptics along with clozapine, the incidence of at least one seizure was 26.67 % (4 out of 15), and among those not receiving antiepileptics, the incidence of at least one seizure was 25 % (5 out of 20). The dose of clozapine at which seizure was noted ranged from 12.5 mg to 600 mg/day with a mean of 236.25 (SD: 169.04; Median: 162.5) mg/day. In none of the patients, clozapine had to be stopped due to the continuation of seizures.
CONCLUSIONS: About one-fourth of the patients with history of an episode of seizure have recurrence of seizure while receiving clozapine. The demographic and clinical variables do not differ between those who develop and who do not develop seizures after starting clozapine, including concomitant use of antiepileptics.
OBJECTIVE: To assess the safety of clozapine in patients with history of seizures in their lifetime before starting clozapine and receiving clozapine for the management of psychotic disorders.
RESULTS: Out of the 958 patients, 35 (3.65 %) had a history of at least one seizure episode before starting clozapine, with a mean of 5.06 (SD: 7.23; Median: 3.00) seizures before starting clozapine. The mean duration between the last seizure and the starting of clozapine was 123.75 (SD: 124.99; Median: 84) months, with nine patients having an episode of seizure in the previous 12 months and 15 patients being seizure-free for more than ten years. About one-fourth (25.7 %; nine out of 35) of the patients had recurrence of seizure while receiving clozapine for a mean duration of about five years. When the recurrence of seizure after starting clozapine was evaluated in patients receiving antiepileptics along with clozapine, the incidence of at least one seizure was 26.67 % (4 out of 15), and among those not receiving antiepileptics, the incidence of at least one seizure was 25 % (5 out of 20). The dose of clozapine at which seizure was noted ranged from 12.5 mg to 600 mg/day with a mean of 236.25 (SD: 169.04; Median: 162.5) mg/day. In none of the patients, clozapine had to be stopped due to the continuation of seizures.
CONCLUSIONS: About one-fourth of the patients with history of an episode of seizure have recurrence of seizure while receiving clozapine. The demographic and clinical variables do not differ between those who develop and who do not develop seizures after starting clozapine, including concomitant use of antiepileptics.
摘要：
背景：癫痫发作被认为是氯氮平的可怕副作用之一，由于这个原因,对于难治性精神分裂症患者,避免使用氯氮平.结果，关于癫痫患者使用氯氮平的信息很少。
目的：评估在开始服用氯氮平和接受氯氮平治疗精神病之前有癫痫发作史的患者一生中使用氯氮平的安全性。
结果：在958名患者中，35（3.65%）在开始服用氯氮平之前有至少一次癫痫发作史，开始氯氮平之前的平均发作为5.06（SD：7.23；中位数：3.00）。上次发作与开始服用氯氮平之间的平均持续时间为123.75（SD：124.99；中位数：84）个月，其中9名患者在过去12个月内发生癫痫发作，15名患者在10年以上没有癫痫发作。约四分之一（25.7％；35例中有9例）的患者在接受氯氮平治疗时平均发作时间约为5年。当在接受抗癫痫药物和氯氮平的患者中评估开始服用氯氮平后癫痫发作的复发时，至少一次癫痫发作的发生率为26.67％（15人中有4人），在那些没有接受抗癫痫药的人中，至少1次癫痫发作的发生率为25%(20次中的5次).发现癫痫发作时氯氮平的剂量范围为12.5mg至600mg/天，平均为236.25mg/天（SD：169.04；中位数：162.5）。在没有一个病人中，由于癫痫持续发作，氯氮平不得不停止。
结论：约有1/4有癫痫发作史的患者在接受氯氮平时出现癫痫发作复发。开始服用氯氮平后发生和未发生癫痫发作的人群之间的人口统计学和临床变量没有差异，包括同时使用抗癫痫药。
目的：评估在开始服用氯氮平和接受氯氮平治疗精神病之前有癫痫发作史的患者一生中使用氯氮平的安全性。
结果：在958名患者中，35（3.65%）在开始服用氯氮平之前有至少一次癫痫发作史，开始氯氮平之前的平均发作为5.06（SD：7.23；中位数：3.00）。上次发作与开始服用氯氮平之间的平均持续时间为123.75（SD：124.99；中位数：84）个月，其中9名患者在过去12个月内发生癫痫发作，15名患者在10年以上没有癫痫发作。约四分之一（25.7％；35例中有9例）的患者在接受氯氮平治疗时平均发作时间约为5年。当在接受抗癫痫药物和氯氮平的患者中评估开始服用氯氮平后癫痫发作的复发时，至少一次癫痫发作的发生率为26.67％（15人中有4人），在那些没有接受抗癫痫药的人中，至少1次癫痫发作的发生率为25%(20次中的5次).发现癫痫发作时氯氮平的剂量范围为12.5mg至600mg/天，平均为236.25mg/天（SD：169.04；中位数：162.5）。在没有一个病人中，由于癫痫持续发作，氯氮平不得不停止。
结论：约有1/4有癫痫发作史的患者在接受氯氮平时出现癫痫发作复发。开始服用氯氮平后发生和未发生癫痫发作的人群之间的人口统计学和临床变量没有差异，包括同时使用抗癫痫药。
