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Long-term effect on outcome of clozapine in chronic therapy-resistant schizophrenic patients

Published online by Cambridge University Press:  16 April 2020

LH Lindström  and
T Lundberg
LH Lindström
Affiliation:
Department of Psychiatric Research, University of Uppsala, Västerås Central Hospital, S-721 89Västerås, Sweden
T Lundberg
Affiliation:
Department of Psychiatric Research, University of Uppsala, Västerås Central Hospital, S-721 89Västerås, Sweden
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Summary

Controlled clinical trials have shown that the atypical neuroleptic clozapine is highly effective in schizophrenic patients who are unresponsive to conventional neuroleptic agents. The long-term outcome of clozapine treatment was studied in 122 patients who were treated between 1974 and 1991. The mean duration of treatment was 5.2 years. At follow-up, 74 patients (61%) were still receiving clozapine. Only 11 patients discontinued treatment because of adverse events and eight because of poor compliance. Clinical improvement was seen in 87% of patients; 40% had resumed employment after 2 years' treatment. About one-third of patients who received clozapine for 5–10 years continued to improve during this time; this was probably because of a continuing process of socialisation. Thus, clozapine offers important advantages in schizophrenic patients resistant to conventional neuroleptics in terms of long-term efficacy and lack of extrapyramidal side-effects.

Keywords

clozapinetreatment-resistant schizophreniaclinical improvementlong-term efficacyneuroleptics
Type
Research Article
Information
European Psychiatry , Volume 12 , Issue S5 , 1997 , pp. 353s - 355s
Copyright
Copyright © Elsevier, Paris 1997

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References

Breier, ABuchanan, RWKirkpatrick, BDavis, ORIrish, DSummerfelt, ACarpenter, WTJ. Effects of clozapine on positive and negative symptoms in outpatients with schizophrenia. Am J Psychiatry 1994; 151: 20–26Google ScholarPubMed
Buchanan, RW. Clozapine: efficacy and safety. Schizophr Bull 1995; 21: 579–591CrossRefGoogle ScholarPubMed
Ekblom, BHaggstrom, JE. Clozapine (Leponex) compared with chlorpromazine: a double-blind evaluation of pharmacological and clinical properties. Curr Ther Res 1974; 16: 945–957Google ScholarPubMed
Gerlach, JKoppelhus, PHelweg, EMonrad, A. Clozapine and haloperidol in a single blind cross over trial: therapeutic and biochemical aspects in the treatment of schizophrenia. Acta Psychiatr Scand 1974; 50: 410–424CrossRefGoogle Scholar
Guirguis, EVoineskos, GGray, JSchlieman, E. Clozapine (Leponex) vs chlorpromazine (Largactil) in schizophrenia (a double-blind controlled study). Curr Ther Res 1977; 21: 707–719Google Scholar
Hogan, TAward, AEastwood, R. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychol Med 1983; 13: 177–183CrossRefGoogle ScholarPubMed
Kane, JM. Treatment of schizophrenia. Schizophr Bull 1987; 13: 133–156CrossRefGoogle ScholarPubMed
Kane, JMHonigfeld, GSinger, JMeltzer, HThe Clozaril Collaborative Study Group. Clozapine for the treatment resistant schizophrenic: a double-blind comparison with chlorpromazine. Arch Gen Psychiatry 1988; 45: 789–796CrossRefGoogle ScholarPubMed
Kane, JMWoerner, MSafferman, APollack, SLieberman, J. Does clozapine cause tardive dyskinesia?. J Clin Psychiatry 1993; 54: 327–330Google ScholarPubMed
Kinon, BJLieberman, JA. Mechanisms of action of atypical antipsychotic drugs: a critical analysis. Psychopharmacology 1996; 124: 2–34CrossRefGoogle ScholarPubMed
Lindström, LH. 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 1988; 77: 524–529CrossRefGoogle ScholarPubMed
Mallya, ARRoos, PDRoebuck-Colgan, K. Restraint, seclusion and clozapine. J Clin Psychiatry 1992; 53: 395–397Google ScholarPubMed
Meltzer, HYOkalyi, G. Reduction of suicidality during clozapine treatment of neuroleptic-resistant schizophrenia: impact on risk-benefit assessment. Am J Psychiatry 1995; 152: 183–190Google ScholarPubMed
Meltzer, HYLee, MARanjan, RMason, EACola, PA. Relapse following clozapine withdrawal: effect of neuroleptic drugs and cyproheptadine. Psychopharmacology 1996; 124: 176–187CrossRefGoogle ScholarPubMed
Okalyi, GRanjan, RMeltzer, HY. A reduction of suicidality during clozapine treatment in neuroleptic-resistant schizophrenia. Schizophr Res 1994; 11: 103–104Google Scholar
Pantelis, CBarnes, TR. Drug strategies and treatment-resistant schizophrenia. Aust N Z J Psychiatry 1996; 30: 20–37CrossRefGoogle ScholarPubMed
Pickar, D. Prospects for pharmacotherapy of schizophrenia. Lancet 1995; 345: 557–562CrossRefGoogle ScholarPubMed
Schooler, NKane, JMarder, Set al.. Efficacy of clozapine vs haloperidol in a long-term clinical trial: preliminary findings. American College of Neuropsychopharmacology Meeting San Juan, Puerto Rico1994Google Scholar
Shopsin, BKlein, HAaronsom, MCollora, M. Clozapine, chlorpromazine, and placebo in newly hospitalized, acutely schizophrenic patients. Arch Gen Psychiatry 1979; 36: 657–664CrossRefGoogle ScholarPubMed
VariousClozapine (suppl) Proceedings of the Scientific Update Meeting Montreux Switzerland, October 31–November 1, 1988 Psychopharmacology 99 1989; S1–S125Google Scholar
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