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Psychopharmacology

, Volume 99, Supplement 1, pp S68–S72 | Cite as

A prospective study of clozapine in treatment-resistant schizophrenic patients

I. Preliminary report
  • H. Y. Meltzer
  • B. Bastani
  • K. Young Kwon
  • L. F. Ramirez
  • S. Burnett
  • J. Sharpe
Article

Abstract

Preliminary results of a non-blinded prospective study of the effect of clozapine on symptomatology and social function in 51 treatment-resistant schizophrenic patients are reported. The mean duration of treatment at the time of this report was 10.3±8.1 months, median 7.6 months. Overall, 3/51 patients (60.8%) showed at least a 20% decrease in total BPRS, a criterion of improvement in the study of Kane et al. (1988). Four of 51 (7.8%) had at least a 50% decrease in total BPRS. Improvements in both positive and negative symptoms were noted. Marked improvements in social function were noted within the first 6 months of treatment. Improvement was first noted at all time points, with only 45.2% of improvers being identified after 6 weeks of treatment. These results suggest a 6–12-month trial may be desirable before deciding to discontinue clozapine because of insufficient response. Higher total Brief Psychiatric Rating Scale (BPRS) score and higher ratings on the Paranoid Disturbance subscales of the BPRS were factors which discriminated clozapine responders from non-responders.

Key words

Clozapine Treatment-resistant schizophrenia Quality of life 

References

  1. Claghorn J, Honigfeld G, Abuzzahab FS, Wang R, Steinbook R, Tuason V, Klerman G (1987) The risks and benefits of clozapine versus chlorpromazine. J Clin Psychopharmacol 7:377–384Google Scholar
  2. Endicott J, Spitzer RL (1978) A diagnostic interview: the Schedule for Affective Disorders and schizophrenia. Arch Gen Psychiatry 35:837–844Google Scholar
  3. Heinrichs DW, Hanlon ET, Carpenter WT Jr (1984) The Quality of Life scale: an instrument for rating the schizophrenic deficit syndrome. Schizophren Bull 10:388–396Google Scholar
  4. Juul-Povlsen VJ, Noring V, Fog R, Gerlach J (1985) Tolerability and therapeutic effect of clozapine: a retrospective investigation of 216 patients treated with clozapine for up to 12 years. Acta Psychiatr Scand 71:176–185Google Scholar
  5. Kane J, Honigfeld G, Singer J, Meltzer H (1988) Clozapine for the treatment-resistant schizophrenic. A double-blind comparison versus chlorpromazine/benztropine. Arch Gen Psychiatry 45:789–796Google Scholar
  6. Krupp P (1989) Granulocytopenia associated with Leponex: A review of the situation. Psychopharmacology (in press)Google Scholar
  7. Kuha S, Miettinen E (1986) Long-term effect of clozapine in schizophrenia: a retrospective study of 108 chronic schizophrenics treated with clozapine for up to 7 years. Nord Psychiatr Tidskr 40:225–230Google Scholar
  8. Lehman AF (1983) The well-being of chronic mental patients: assessing their quality of life. Arch Gen Psychiatry 40:369–373Google Scholar
  9. Lindström LH (1988) The effect of long-term treatment with clozapine in schizophrenia: a retrospective study in 96 patients treated with clozapine for up to 13 years. Acta Psychiatr Scand 77:524–529Google Scholar
  10. Overall JE, Gorham DR (1962) Brief Psychiatric Rating Scale (BPRS). Psychol Rep 10:799–812Google Scholar
  11. Wing JK, Cooper JE, Sartorius A (1974) The measurement and classification of psychiatric symptoms. Cambridge University Press, LondonGoogle Scholar

Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • H. Y. Meltzer
    • 1
  • B. Bastani
    • 1
  • K. Young Kwon
    • 2
  • L. F. Ramirez
    • 1
  • S. Burnett
    • 1
  • J. Sharpe
    • 1
  1. 1.Department of PsychiatryCase Western Reserve University School of MedicineClevelandUSA
  2. 2.Cleveland Veterans Administration HospitalClevelandUSA

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