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Article: The incidence and characteristics of clozapine-induced fever in a local psychiatric unit in Hong Kong

TitleThe incidence and characteristics of clozapine-induced fever in a local psychiatric unit in Hong Kong
Authors
KeywordsChinese
Clozapine
Fever
Hong Kong
Issue Date2008
PublisherCanadian Psychiatric Association. The Journal's web site is located at http://www.cpa-apc.org/Publications/cjpHome.asp
Citation
Canadian Journal Of Psychiatry, 2008, v. 53 n. 12, p. 857-862 How to Cite?
AbstractObjective: To determine the incidence, characteristics, and predictors of clozapine-induced fever in a sample of patients in a local psychiatric unit. Method: A retrospective review of case notes of 227 inpatients newly started on clozapine from March 2003 to December 2006 was conducted. Demographic characteristics, presence of fever, investigations carried out, fever characteristics, and complications of fever were recorded and analyzed. Patients with clozapine-induced fever were compared with their fever-free counterparts on demographic and clinical factors. Multivariate logistic regression was performed to identify predictors of clozapine-induced fever. Results: Thirty-one out of 227 patients (13.7%) developed clozapine-induced fever. The means for day of onset of clozapine-induced fever after clozapine initiation and duration of fever were 13.7 and 4.7 days, respectively. The mean highest body temperature was 38.8°C. Fever resolved within 48 hours after clozapine discontinuation in 79% of the patients with clozapine-induced fever. One out of 7 patients (14.3%) had fever on re-challenge. Clozapine-induced fever was associated with rate of titration more than 50 mg/wk (OR 18.9; 95% CI 5.3 to 66.7; P < 0.01), concomitant use of valproate (OR 3.6; 95% CI 1.5 to 8.9; P = 0.01), and presence of physical illnesses (OR 3.2; 95% CI 1.2 to 8.3; P = 0.02). Conclusion: Clozapine-induced fever is common. Temporary withdrawal of clozapine may result in resolution of fever, and clozapine re-challenge may be considered after fever subsides. Slower rate of clozapine titration may be helpful in patients with underlying physical illness and concomitant valproate treatment.
Persistent Identifierhttp://hdl.handle.net/10722/59714
ISSN
2015 Impact Factor: 2.952
2015 SCImago Journal Rankings: 1.631
References

 

DC FieldValueLanguage
dc.contributor.authorChung, JPYen_HK
dc.contributor.authorChong, CSYen_HK
dc.contributor.authorChung, KFen_HK
dc.contributor.authorDunn, ELWen_HK
dc.contributor.authorTang, OWNen_HK
dc.contributor.authorChan, WFen_HK
dc.date.accessioned2010-05-31T03:55:56Z-
dc.date.available2010-05-31T03:55:56Z-
dc.date.issued2008en_HK
dc.identifier.citationCanadian Journal Of Psychiatry, 2008, v. 53 n. 12, p. 857-862en_HK
dc.identifier.issn0706-7437en_HK
dc.identifier.urihttp://hdl.handle.net/10722/59714-
dc.description.abstractObjective: To determine the incidence, characteristics, and predictors of clozapine-induced fever in a sample of patients in a local psychiatric unit. Method: A retrospective review of case notes of 227 inpatients newly started on clozapine from March 2003 to December 2006 was conducted. Demographic characteristics, presence of fever, investigations carried out, fever characteristics, and complications of fever were recorded and analyzed. Patients with clozapine-induced fever were compared with their fever-free counterparts on demographic and clinical factors. Multivariate logistic regression was performed to identify predictors of clozapine-induced fever. Results: Thirty-one out of 227 patients (13.7%) developed clozapine-induced fever. The means for day of onset of clozapine-induced fever after clozapine initiation and duration of fever were 13.7 and 4.7 days, respectively. The mean highest body temperature was 38.8°C. Fever resolved within 48 hours after clozapine discontinuation in 79% of the patients with clozapine-induced fever. One out of 7 patients (14.3%) had fever on re-challenge. Clozapine-induced fever was associated with rate of titration more than 50 mg/wk (OR 18.9; 95% CI 5.3 to 66.7; P < 0.01), concomitant use of valproate (OR 3.6; 95% CI 1.5 to 8.9; P = 0.01), and presence of physical illnesses (OR 3.2; 95% CI 1.2 to 8.3; P = 0.02). Conclusion: Clozapine-induced fever is common. Temporary withdrawal of clozapine may result in resolution of fever, and clozapine re-challenge may be considered after fever subsides. Slower rate of clozapine titration may be helpful in patients with underlying physical illness and concomitant valproate treatment.en_HK
dc.languageengen_HK
dc.publisherCanadian Psychiatric Association. The Journal's web site is located at http://www.cpa-apc.org/Publications/cjpHome.aspen_HK
dc.relation.ispartofCanadian Journal of Psychiatryen_HK
dc.subjectChineseen_HK
dc.subjectClozapineen_HK
dc.subjectFeveren_HK
dc.subjectHong Kongen_HK
dc.titleThe incidence and characteristics of clozapine-induced fever in a local psychiatric unit in Hong Kongen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0706-7437&volume=53 &issue=12&spage=857&epage=862&date=2008&atitle=The+Incidence+and+Characteristics+of+Clozapine-Induced+Fever+in+a+Local+Psychiatric+Unit+in+Hong+Kongen_HK
dc.identifier.emailChung, KF: kfchung@hkucc.hku.hken_HK
dc.identifier.authorityChung, KF=rp00377en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid19087484-
dc.identifier.scopuseid_2-s2.0-58149260289en_HK
dc.identifier.hkuros155920en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-58149260289&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume53en_HK
dc.identifier.issue12en_HK
dc.identifier.spage857en_HK
dc.identifier.epage862en_HK
dc.publisher.placeCanadaen_HK
dc.identifier.scopusauthoridChung, JPY=25935962000en_HK
dc.identifier.scopusauthoridChong, CSY=25629318300en_HK
dc.identifier.scopusauthoridChung, KF=7404086681en_HK
dc.identifier.scopusauthoridDunn, ELW=8610805000en_HK
dc.identifier.scopusauthoridTang, OWN=7006723395en_HK
dc.identifier.scopusauthoridChan, WF=8610805400en_HK

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