Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-20T11:33:04.076Z Has data issue: false hasContentIssue false
  • English
  • Français

Ten years' experience with clozapine in treatment-resistant schizophrenic patients: Factors indicating the therapeutic response

Published online by Cambridge University Press:  16 April 2020

E Alvarez ,
F Barón ,
J Perez-Blanco ,
D Puigdemont José Soriano ,
C Masip  and
V Perez-Solá
E Alvarez
Affiliation:
Servei di Psiquiatria, Hospital de la Santa Creu I Sant Pau, Avenida Sant Antoni Maria Claret 165, 08025Barcelona, Spain
F Barón
Affiliation:
Servei di Psiquiatria, Hospital de la Santa Creu I Sant Pau, Avenida Sant Antoni Maria Claret 165, 08025Barcelona, Spain
J Perez-Blanco
Affiliation:
Servei di Psiquiatria, Hospital de la Santa Creu I Sant Pau, Avenida Sant Antoni Maria Claret 165, 08025Barcelona, Spain
D Puigdemont José Soriano
Affiliation:
Servei di Psiquiatria, Hospital de la Santa Creu I Sant Pau, Avenida Sant Antoni Maria Claret 165, 08025Barcelona, Spain
C Masip
Affiliation:
Servei di Psiquiatria, Hospital de la Santa Creu I Sant Pau, Avenida Sant Antoni Maria Claret 165, 08025Barcelona, Spain
V Perez-Solá
Affiliation:
Servei di Psiquiatria, Hospital de la Santa Creu I Sant Pau, Avenida Sant Antoni Maria Claret 165, 08025Barcelona, Spain
Get access

Summary

A prospective study in treatment-resistant schizophrenic patients was performed over 10 years to evaluate the therapeutic response to clozapine and the variables related to this treatment. Eighty schizophrenic and schizoaffective patients (according to Diagnostic and Statistical Manual [DSM]-IIIR criteria), considered as refractory (previously resistant to at least two different typical neuroleptics), were studied. The average dose of clozapine was 267 mg/d. The clinical variables considered were: Brief Psychiatric Rating Scale (BPRS), number of admissions before and after clozapine treatment and the Strauss-Carpenter scale as measures of efficacy; Premorbid Adjustment Scale (PAS), to assess personal and social adjustment before illness; Karolinska Personality Scale (KPS) to assess stable traits of personality; and the Simpson-Angus scale as a measure of extrapyramidal symptoms. Sixty percent of patients showed a significant improvement after clozapine treatment. Side-effects were mild and well tolerated, with no cases of haematological disturbance and only five withdrawals because of adverse events. The severity of the episode, according to BPRS score and anxiety as a personal trait, are related to good prognosis. Other relationships between improvement and clinical and demographic variables are discussed.

Keywords

clozapinetreatment-resistant schizophreniatherapeutic response
Type
Research Article
Information
European Psychiatry , Volume 12 , Issue S5 , 1997 , pp. 343s - 346s
Copyright
Copyright © Elsevier, Paris 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alvarez, EGarcia, CTorrens, MUdina, CGuillamat, RCasas, M. Premorbid adjustment scale as a prognostic predictor for schizophrenia (Letter). Br J Psychiatry 1987; 150: 411CrossRefGoogle Scholar
Cannon-Spoor, HEPotkin, SGWyatt, RJ. Measurement of premorbid adjustment in chronic schizophrenia. Schizophr Bull 1982; 8: 470–484CrossRefGoogle ScholarPubMed
Faraone, SVBrown, WALaughren, TP. Serum neuroleptic levels, prolactin levels and relapse: a two year study of schizophrenic patients. J Clin Psychiatry 1987; 48: 151–154Google Scholar
Garcia Ribera, CTorrens, MGuillamat, RRuiz, IUdina, CCasas, MAlvarez, E. La escala de ajuste premórbido y el pronóstico de la esquizofrenia. Sant Pau 1986; 7: 95Google Scholar
Garcia Ribera, CTorrens, MGuillamat, RRuiz, IUdina, CCasas, MAlvarez, E. La escala de ajuste premórbido y el pronóstico de la esquizofrenia. Sant Pau 1986; 7: 103Google Scholar
Kane, JMHonigfeld, GSinger, JMeltzer, HThe Clozaril Collaborative Study Group. Clozapine for the treatment resistant schizophrenic: a double-blind comparison with chlorpromazine. Arch Gen Psychiatry 45 1988 789–796CrossRefGoogle ScholarPubMed
Kay, SRSingh, MM. The positive-negative distinction in drug-free schizophrenic patients. Arch Gen Psychiatry 1989; 46: 711–718CrossRefGoogle ScholarPubMed
Klinteberg, BSchalling, DMagnusson, DIndividual development and adjustment. Self-report assessment of personality traits. Geneva: University of Stockholm, Department of Psychology, 1986Google Scholar
Meltzer, HYClozapine. Pattern of efficacy in treatment-resistant schizophreniaMeltzer, HYNovel antipsychotic drugs Stockholm: Raven Press, 1992; 33–46Google Scholar
Ministerio de Sanidad y Consumo. Centro Nacional de Farmacobiologia, Area de Farmacologia. Programa de Seguimiento de Clozapina. Boletin Informativo no 2 1996Google Scholar
Nasrallah, HARelationship of structural brain changes to antipsychotic drug response in schizophreniaShiriqui, CLNasrallah, HAContemporary issues in the treatment of schizophrenia New York: American Psychiatry Press, 1995; 209–223Google Scholar
Ortet-Fabregat, GTorrubia, R. Spanish language version of the Karolinska Scales of Personality (KPS): first data. 6th European Association for Personality Psychology ConferenceGroningen, The Netherlands1994Google Scholar
Overall, JEGorham, DR. The Brief Psychiatric Rating Scale. Psychol Rep 1962; 10: 799–812CrossRefGoogle Scholar
Pickar, DOwen, RRLitman, RE. Clinical and biologic response to clozapine in patients with schizophrenia: crossover comparison with fluphenazine. Arch Gen Psychiatry 1992; 49: 345–353CrossRefGoogle ScholarPubMed
Simpson, GMAngus, JWS. A rating scale for extrapyramidal side effects. Acta Psychiatr Scand Suppl 1970; 46: 11–19CrossRefGoogle Scholar
Strauss, JSCarpenter, WT. The prediction of outcome in schizophrenia. I. Characteristics of outcome. Arch Gen Psychiatry 1972; 27: 739–746CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.