|LETTER TO EDITOR
|Year : 2017 | Volume
| Issue : 1 | Page : 103-104
Clozapine use in adolescents
Samir Kumar Praharaj
Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India
|Date of Web Publication||24-Jan-2017|
Samir Kumar Praharaj
Department of Psychiatry, Kasturba Medical College, Manipal - 576 104, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Praharaj SK. Clozapine use in adolescents. Indian J Psychol Med 2017;39:103-4
I read with interest the study on metabolic disturbances, side effect profile and effectiveness of clozapine in adolescents by Grover et al. in May–June issue of 2016. As the authors suggest clozapine is probably underused in adolescents, although it is not only found to be effective in early-onset treatment-resistant schizophrenia,, but also in treatment-refractory mania, autistic spectrum disorder, severe conduct disorder, and intermittent explosive disorder.
There are indeed very few reports of safety and effectiveness of the use of clozapine in adolescent population from India. Although limited by small sample, the authors have followed up the cohort for more than 6 months and have systematically examined metabolic syndrome and its components. The prevalence and incidence rates of metabolic disturbances in adolescents exposed to clozapine are high in this study, which occurs more often in comparison to adults.
The authors have reported results separately for complete data (n = 9) and imputed data (n = 13) using the last observation carried forward method. For all categorical data, repeated measures ANOVA and post hoc paired t-test were used. However, for categorical data, Pearson's Chi-square test or Fisher's exact test was used; both of these are tests of independence of proportions and are used when two independent groups are compared., Instead, for paired binary data, a Chi-square test for within group design, called McNemar's test is used, and for multiple paired binary data, Cochran's Q-test would be appropriate., It is suggested that in the current study, Cochran's Q-test may be used to compare proportions over three-time points, followed by post hoc McNemar's test.
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