The Common Side Effects of Long Term Treatment with Clozapine and Their Impact: a Sri Lankan Experience

Abstract

Objectives To analyse the side effects experienced by patients who are on clozapine for a period of more than one year and to analyse the impact of the side effects. Methods A descriptive cross sectional study carried out in University Psychiatry unit, National Hospital of Sri Lanka, Colombo. All patients attending the clozapine clinic within one month and who are on clozapine for a period of more than one year and who are in remission were selected. Interviewer administered questionnaire was used to assess the presence of side effects and their impact. Data was analyzed using SPSS software. Results Sample was 63. Mean age was 34.9 years (range 18-60). Mean duration of usage of clozapine is 7.0 years (range 1-20). Fifty seven (71.4%) had hyper-salivation and constipation and 12 (19.0%) had nocturnal enuresis. Majority of patients who had hyper-salivation (86.6%) and nocturnal enuresis (100%) were not receiving any medical intervention. Fifteen (23.8%) reported the side effects have caused distress for them and 19% (n=12) revealed they have affected their activities of daily living. Conclusions Most common long term side effects were hyper-salivation and constipation. Majority of patients with hyper-salivation were not receiving medical intervention. Majority of patients did not report that the side effects affect their activities of daily living or they cause personal distress.