{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:15:22Z","timestamp":1758845722787,"version":"3.44.0"},"reference-count":11,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PCN Reports"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>22q11.2 deletion syndrome is associated with schizophrenia, seizures, and often experience intolerance to antipsychotics. Periventricular nodular heterotopia (PNH) is a neuronal migration disorder that can also be observed in individuals with 22q11.2 deletion syndrome. However, to our knowledge, the use of clozapine in adolescent patients with treatment\u2010resistant schizophrenia and comorbid 22q11.2 deletion syndrome and PNH has not been previously reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>A 17\u2010year\u2010old female with treatment\u2010resistant schizophrenia was referred to our hospital. She presented with auditory hallucinations, disorganized behavior, and insomnia. Multiple antipsychotics, mood stabilizers, benzodiazepines, and modified electroconvulsive therapy were either ineffective or poorly tolerated due to extrapyramidal symptoms. Brain magnetic resonance imaging (MRI) performed under sedation revealed PNH. Genetic testing confirmed a diagnosis of 22q11.2 deletion syndrome. Clozapine was initiated with close monitoring, and her symptoms gradually improved following a slow titration. She was discharged after approximately 6 months and has remained clinically stable for 15 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Brain MRI and genetic testing\u2014even when performed under sedation\u2014may be valuable diagnostic tools in adolescents with treatment\u2010resistant schizophrenia. Furthermore, the presence of structural brain abnormalities does not preclude the efficacy of clozapine, which may remain a viable and effective treatment option in such cases.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pcn5.70195","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T07:02:39Z","timestamp":1756105359000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Successful use of clozapine in a patient with schizophrenia comorbid with 22q11.2 deletion syndrome and multiple periventricular nodular heterotopia: A case report"],"prefix":"10.1002","volume":"4","author":[{"given":"Kiwamu","family":"Hoshi","sequence":"first","affiliation":[{"name":"Department of Psychiatry Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4287-446X","authenticated-orcid":false,"given":"Koichi","family":"Matsuyama","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4957-5847","authenticated-orcid":false,"given":"Yasunori","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shintaro","family":"Shibata","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teruomi","family":"Iyo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeru","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuki","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4898-3905","authenticated-orcid":false,"given":"Fumiaki","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumiaki","family":"Yamasaki","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Nakata","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8502-6469","authenticated-orcid":false,"given":"Tsuyoshi","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Child Psychiatry Chiba University Hospital Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomihisa","family":"Niitsu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"volume-title":"22q11.2 deletion syndrome","year":"1993","author":"McDonald\u2010McGinn DM","key":"e_1_2_12_2_1"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.02.039"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/07067437241293983"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-3995(02)01114-0"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.12322"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7283"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/13.2.261"},{"volume-title":"Diagnostic and statistical manual of mental disorders","year":"1980","author":"American Psychiatric Association","key":"e_1_2_12_9_1"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0000000000001816"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aaf7073"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.641"}],"container-title":["Psychiatry and Clinical Neurosciences Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pcn5.70195","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T10:40:28Z","timestamp":1758796828000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pcn5.70195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,25]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/pcn5.70195"],"URL":"https:\/\/doi.org\/10.1002\/pcn5.70195","archive":["Portico"],"relation":{},"ISSN":["2769-2558","2769-2558"],"issn-type":[{"type":"print","value":"2769-2558"},{"type":"electronic","value":"2769-2558"}],"subject":[],"published":{"date-parts":[[2025,8,25]]},"assertion":[{"value":"2025-05-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70195"}}