TERAPI CLOZAPINE PADA SKIZOFRENIA KATATONIK DENGAN KEHAMILAN: LAPORAN KASUS
DOI:
https://doi.org/10.51878/healthy.v3i1.3033Keywords:
Clozapine, kehamilan, skizofrenia katatonik, antipsikotikAbstract
The use of clozapine in pregnant women with catatonic schizophrenia is still rarely reported and raises concerns regarding its safety. This study aims to describe the effectiveness and safety of using low-dose clozapine in pregnant women with catatonic schizophrenia. Case report of a 27 year old woman with catatonic schizophrenia who was given low dose clozapine therapy (6.25 mg/day) during the second trimester of pregnancy until delivery. The primary focus is on response to clozapine and pregnancy outcomes. Administration of low doses of clozapine resulted in significant improvements in patient communication without significant side effects. Although the dose is well below the common therapeutic dose, clozapine is effective in managing the symptoms of catatonia. The baby was born via caesarean section at 39 weeks 5 days of gestation with a weight of 3000 grams, a length of 48 cm, and an Apgar score of 8-9, without congenital abnormalities. Evaluation one month after delivery did not show any complications related to the use of clozapine in the mother and baby. The use of low-dose clozapine in this case represents a promising approach in managing catatonic schizophrenia during pregnancy, with good outcomes in both mother and baby. Clozapine appears to be effective even at very low doses, offering a balance between symptom management and fetal safety. However, further research is needed to confirm the long-term safety profile and effectiveness of low-dose clozapine in this population.
ABSTRAK
Penggunaan clozapine pada ibu hamil dengan skizofrenia katatonik masih jarang dilaporkan dan menimbulkan kekhawatiran terkait keamanannya. Studi ini bertujuan untuk menggambarkan efektivitas dan keamanan penggunaan clozapine dosis rendah pada pasien ibu hamil dengan skizofrenia katatonik. Laporan kasus seorang wanita berusia 27 tahun dengan skizofrenia katatonik yang diberikan terapi clozapine dosis rendah (6,25 mg/hari) selama kehamilan trimester kedua hingga persalinan. Fokus utama adalah pada respons terhadap clozapine dan hasil kehamilan. Pemberian clozapine dosis rendah menghasilkan perbaikan yang signifikan dalam komunikasi pasien tanpa efek samping yang berarti. Meskipun dosisnya jauh di bawah dosis terapeutik umum, clozapine efektif dalam mengelola gejala katatonia. Bayi lahir melalui sectio caesaria pada usia kehamilan 39 minggu 5 hari dengan berat 3000 gram, panjang 48 cm, dan Apgar score 8-9, tanpa kelainan kongenital. Evaluasi satu bulan pasca persalinan tidak menunjukkan adanya komplikasi terkait penggunaan clozapine pada ibu dan bayi. Penggunaan clozapine dosis rendah pada kasus ini menunjukkan pendekatan yang menjanjikan dalam mengelola skizofrenia katatonik selama kehamilan, dengan hasil yang baik pada ibu dan bayi. Clozapine tampaknya efektif bahkan pada dosis yang sangat rendah, menawarkan keseimbangan antara manajemen gejala dan keamanan janin. Namun, diperlukan penelitian lebih lanjut untuk mengonfirmasi profil keamanan jangka panjang dan efektivitas clozapine dosis rendah dalam populasi ini.
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