Effectiveness of Clozapine and Its Potential Drug-Drug Interactions in Patients with Schizophrenia: A Study in Referral Psychiatric Hospital
DOI:
https://doi.org/10.20527/jps.v12i2.23111Keywords:
Clozapine, Schizophrenia, Effectiveness, Influencing Factor, Drug-Drug InteractionsAbstract
ABSTRAK Penelitian terkait efektivitas klozapin pada populasi Asia, baik sebagai monoterapi atau kombinasi, masih sangat terbatas. Selain itu, potensi interaksi antar-obat sering dijumpai pada pasien skizofrenia. Penelitian ini bertujuan untuk menganalisis respon terapeutik klozapin dan faktor-faktor yang memengaruhinya, serta interaksi obat-obat yang bersifat potensial. Penelitian cross-sectional retrospektif ini menggunakan data sekunder dari rekam medik pasien di rumah sakit jiwa rujukan di Jawa Tengah, Indonesia. Analisis data menggunakan uji Chi-square atau Fisher’s exact dengan SPSS versi 23. Studi melibatkan 149 pasien skizofrenia dengan mayoritas laki-laki dan terdiagnosis undifferentiated schizophrenia. Sebanyak 89,93% pasien mengalami perbaikan gejala klinis, sesuai yang dinyatakan dokter pada rekam medik, baik pada penggunaan klozapin tunggal maupun kombinasi terutama dengan risperidon. Respon terapeutik klozapin dipengaruhi secara signifikan hanya oleh usia (p<0,05). Sementara itu, interaksi obat potensial dengan klozapin berkategori mayor ditemukan pada 8,1% pasien. Penggunaan bersama risperidon diidentifikasi sebagai interaksi obat mayor terbanyak (79,25%) yang berisiko menimbulkan permasalahan kardiovaskular atau pernapasan. Penelitian ini merekomendasikan studi prospektif dengan penilaian efektivitas klozapin menggunakan PANSS-ES maupun dampak klinis interaksi obatnya. Kata Kunci: Klozapin, Skzofrenia, Efektivitas, Faktor Yang Memengaruhi, Interaksi Obat-Obat  Studies on clozapine effectiveness among Asian populations, either as monotherapy or in combination, are quite limited. In addition, potential drug-drug interactions (DDI) are common in schizophrenic patients. This study aimed to analyze the therapeutic response to clozapine, its influencing factors, and the potential DDI. A cross-sectional study design retrospectively collected secondary data from medication records at the referral psychiatric hospitals in Central Java, Indonesia. Data analysis was performed using the Chi-square test or Fisher's exact test in SPSS version 23.  This study included 149 patients, predominantly male, who were diagnosed with undifferentiated schizophrenia. As many as 89.93% of patients experienced symptom improvement, as stated by the physician in the medical record, either as monotherapy or in combination, especially with risperidone. The therapeutic response to clozapine was significantly influenced only by age (p<0.05). Meanwhile, potential major drug interactions were found in 8.1% of patients. The combined use of clozapine with risperidone has been identified as having the most significant risk for drug interactions (79.25%), which can lead to cardiovascular or respiratory problems. This study recommends conducting prospective studies on the effectiveness of clozapine using the PANSS-ES scale and examine the clinical impact of the drug interactions.References
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