3 results
116 Retrospective Analysis of Clozapine Augmentation in Treatment-Resistant Schizophrenia in an Outpatient Setting
- Charles Odom, Frozan Walyzada, Pankaj Manocha, Monika Gashi, Ashaki Martin, Raminder Cheema, Wen Gu, Ketki Shah, Panagiota Korenis
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- Journal:
- CNS Spectrums / Volume 23 / Issue 1 / February 2018
- Published online by Cambridge University Press:
- 15 June 2018, pp. 73-74
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Study Objectives
This retrospective analysis hopes to add to the literature about Treatment Resistant Schizophrenia (TRS), augmentation strategies with antipsychotics used in our patient population with the hopes of clarifying what possibilities should be further studied. In addition, we aim to emphasize the need for focusing on individualized treatment and multidisciplinary efforts to ensure compliance and appropriate disposition options.
MethodWe reviewed retrospectively 3025 charts of patients between January 2017 to March 2017 in our outpatient department establishing which antipsychotic clozapineaugmentation strategies were being used. We also did a literature review to establish what augmentation strategies are recommended. These patients will then be compared to a random sample of patients in the clinic who were not prescribed clozapine and compared for readmission rate, side effect profile, length of stay while admitted, frequency of clinic attendance and compliance with outpatient appointments.
ResultsOut of 3025 patients 35 were prescribed Clozapine as monotherapy and 5 patients had clozapine plus psychopharmacological augmentation. Ages ranged from 21-86. Out of the 39 patients, there were 13 male and 26 female. The predominant diagnosis was mood disorder or MDD with psychotic features followed by schizophrenia. The augmentation antipsychotics used were aripiprazole and risperidone. In the literature, the most frequent augmentation strategy for TRS is adding another antipsychotic with more D2 receptor blockade. Other strategies involve identifying and treating the symptoms not controlled by clozapine.
ConclusionsCurrently augmentation of Clozapine in TRS is highly individualized due to lack of supporting evidence to state the contrary. When working with treatmentresistant patients who are not responding to clozapine alone, it is imperative to thoroughly review and consider all treatment options and augmentation strategies. More studies should be done in controlled settings to better evaluate possibilities as well as more evaluations to be done on other ways of augmentation of clozapine. Literature has stated between 20-60% of patients are defined as TRS. Clozapine is considered as one of the most effective treatment available at present time for TRS. Recent literature suggests despite its superior efficacy, as many as 70% of those suffering from TRS on clozapine continue to suffer from positive, negative or cognitive symptoms. The literature has abundant adjunctive treatment strategies such as the addition of antipsychotics, mood stabilizers, antidepressants, or even with the use of electroconvulsive therapy. We emphasize the importance of correctly identifying TRS patients who may benefit from the initiation of clozapine, what would be beneficial for them if they do not respond, how to tailor their treatment to target symptoms not being ameliorated, and recommend treatment in these complex cases be multidisciplinary.
Funding AcknowledgementsNo funding.
Scanning Tunneling Microscopy and Spectroscopy Studies of Single Wall Carbon Nanotubes
- Teri Wang Odom, Jin-Lin Huang, Philip Kim, Min Ouyang, Charles M. Lieber
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- Journal:
- Journal of Materials Research / Volume 13 / Issue 9 / September 1998
- Published online by Cambridge University Press:
- 31 January 2011, pp. 2380-2388
- Print publication:
- September 1998
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Scanning tunneling microscopy and spectroscopy have been used to characterize the atomic structure and tunneling density of states of individual single wall carbon nanotubes (SWNT's) and ropes containing many SWNT's. Analysis of atomically resolved SWNT images shows that the nanotubes consist of a wide range of diameters and helicities with no one structure clearly dominant. Tunneling spectroscopy measurements made simultaneously on atomically resolved SWNT's exhibit semiconducting and metallic behavior that depend predictably on helicity and diameter. In addition the band gaps of the semiconducting tubes were also found to depend inversely on diameter. These results are compared to theoretical predictions, and the implications of these studies as well as important future directions are discussed.
Quantitative Materials Analysis by Laser Microprobe Mass Analysis
- Robert W. Odom, Charles J. Hitzman, Bruno W. Schueler
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- Journal:
- MRS Online Proceedings Library Archive / Volume 69 / 1986
- Published online by Cambridge University Press:
- 25 February 2011, 265
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- 1986
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The laser microprobe mass analysis (LMMA) technique currently finds extensive application in the qualitative microanalysis of a wide range of materials. These microanalytical applications include the analysis of polymeric materials [1], semiconductors [2] and particulate samples [3]. These qualitative analyses have repeatedly demonstrated the analytical ability of this technique for producing rapid, elemental, isotopic and, in some cases, molecular characterization of these types of materials. The development of quantitative or semi-quantitative analytical methodologies is the goal of any analytical technique and rather extensive investigation of the quantitative capabilities of the laser microprobe technique have been pursued since the initial development of this technique. These investigations have centered on developing appropriate microanalytical standards [4], characterizing the pertinent physical and chemical processes occurring during high power laser irradiation of materials [5] and modeling the nature and extent of the ionization produced with physically reasonable models [6, 7]. To date, these quantitative studies have generally provided good analytical methods and results and, although the number of quantitative analyses of materials systems have been rather limited, the results do provide sufficient encouragement to pursue further quantitative studies with this technique. In this paper, we discuss the results obtained in a laser microprobe analysis of phosphosilicate glass (PSG) standards in which the quantitative capabilities of the technique for the determination of the phosphorous content of PSG glasses were evaluated. The results of this analysis were compared to those produced from a secondary ion mass spectrometry (SIMS) analysis of these PSG standards. We have also evaluated the in-depth profiling capability of the laser microprobe technique and demonstrate this capability with a depth profile of a 11B implant into Si. Finally, we present preliminary data obtained from a new modification to the basic laser microprobe technique in which the conventional laser system is employed to ablate the sample material and a second laser pulse ionizes the neutral-components in the vapor plume produced by the ablation laser. This two laser configuration of the laser microprobe promises to improve the sensitivity and reproducibility of this microanalysis technique.