Psychopharmacologic Drugs : Antipsychotics
OCLOP3 “Clopine tablet” 25 mg/tab
OCLOZ1 “Clozaril tablet” 100 mg/tab
OZAPI1 “Zapine tablet” 100 mg/tab
適應症：
OCLOP3：其他藥物治療失效的精神分裂症病人。
OCLOZ1, OZAPI1：其他藥物治療失效的精神分裂症病患。降低精神分裂症或情感性分裂症的復發性自殺行為。帕金森氏症期間的精神疾病。
Usual dose:
Schizophrenia, treatment-resistant: initial, 12.5 mg qd-bid, continued with daily dosage increments of 25-50 mg/day, if well-tolerated, achieve a target dose of 300-450 mg/day in 2-3 divided doses by the end of 2 wks.
Schizoaffective disorder – Suicidal behavior, Recurrent: initial, 12.5 mg qd-bid, then continued with daily dosage increments of 25-50 mg/day, if well-tolerated, to achieve a target dose of 300-450 mg/day in 2-3 divided doses by the end of 2 wks; maintenance: dosage adjustments should < 1-2 times/wk, in increments <100 mg; max. 900 mg/day.
Contraindication:
Myeloproliferative disorders, history of clozapine-induced agranulocytosis or severe granulocytopenia, paralytic ileus, severe central nervous system depression or comatose states.
Adverse effect:
Common: hypotension, tachyarrhythmia, rash, sweating symptom, weight gain, constipation, excessive salivation, nausea, xerostomia, motor function behavior finding, muscle rigidity, akathisia, confusion, dizziness, headache, insomnia, somnolence, tremor, vertigo, visual disturbance, agitation, dyssomnia, nightmares, restlessness, disorder of urinary tract, fatigue, fever.
Serious: cardiac arrest, myocarditis, orthostatic hypotension, pericardial effusion, syncope, hyperglycemia, bowel obstruction, colitis, necrotizing, fecal impaction, ischemic bowel disease, pancreatitis, paralytic ileus, perforation of intestine, agranulocytosis, drug-induced eosinophilia, leukopenia, neutropenia, thrombocytopenia, white blood cell finding decreased, hepatitis, neuroleptic malignant syndrome, seizure, tardive dyskinesia, pulmonary embolism, respiratory arrest, death.
健保使用規範：
1.限精神科專科醫師使用；前18週使用時，每週須作白血球檢驗，每次處方以七日為限，使用18週後，每月作一次白血球檢驗；申報費用時，應檢附白血球檢驗報告。
2.需合乎衛生主管機關許可之適應症範圍，並需符合下列條件 (1)開始使用「第二代抗精神病藥品」時需於病歷記載：醫療理由或診斷，以及臨床整體評估表(CGI)之分數；(2)經規則使用六至八週後，需整體評估其療效，並於病歷記載：臨床整體評估表之分數；(3)日劑量超過400 mg/day時，須於病歷記載理由。
3.本類藥品不得使用於雙極性疾患之鬱症發作。(95/10/1)