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附錄一、全民健康保險藥品給付規定(106 年) 1.2.2.抗精神病劑 Antipsychotics
1.2.2.1.Clozapine（如 Clozaril）
1.限精神科專科醫師使用。
2.前 18 週使用時，每週需作白血球檢驗，每次處方以七日為限，使用 18 週後，
每月作一次白血球檢驗。
3.申報費用時，應檢附白血球檢驗報告。
1.2.2.2.Second generation antipsychotics (簡稱第二代抗精神病藥品，如 clozapine、olanzapine、risperidone、quetiapine、amisulpride、ziprasidone、
aripiprazole、paliperidone、lurasidone 等)：(91/9/1、92/1/1、92/7/1、
94/1/1、95/10/1、97/5/1、99/10/1、106/1/1)
1.本類製劑之使用需符合下列條件(95/10/1、97/5/1、99/10/1、106/1/1)：
(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 (Clinical Global Impression，簡 稱 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)日劑量超過下列治療劑量時，需於病歷記載理由：
clozapine 400 mg/day risperidone 6 mg/day olanzapine 20 mg/day quetiapine 600 mg/day
amisulpride 800mg/day (92/1/1) ziprasidone 120mg/day (92/7/1) aripiprazole 15mg/day (94/1/1) paliperidone 12mg/day (97/5/1）
lurasidone 120mg/day (106/1/1）
2.本類藥品不得使用於雙極性疾患之鬱症發作。(95/10/1)
3.Olanzapine 用於預防雙極性疾患復發時，限 lithium、carbamazepine、valproate 等藥品至少使用兩種以上，治療無效或無法耐受副作用時使用。(95/10/1)
附錄二、Clinical Global Impression (CGI) Score
1. Severity of illness
Considering your total clinical experience with this particular population, how mentally ill is the patient at this time?
0 = Not assessed 1 = Normal, not at all ill 2 = Borderline mentally ill 3 = Mildly ill
4 = Moderately ill 5 = Markedly ill 6 = Severely ill
7 = Among the most extremely ill patients
2. Global improvement: Rate total improvement whether or not, in your judgement,
it is due entirely to drug treatment.Compared to his condition at admission to the project, how much has he changed?
0 = Not assessed 1 = Very much improved 2 = Much improved 3 = Minimally improved 4 = No change
5 = Minimally worse 6 = Much worse 7 = Very much worse
3. Efficacy index: Rate this item on the basis of drug effect only.
Select the terms which best describe the degrees of therapeutic effect and side effects and record the number in the box where the two items intersect.
EXAMPLE: Therapeutic effect is rated as „Moderate‟ and side effects are judged „Do not significantly interfere with patient‟s functioning‟.