Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-22T05:18:03.039Z Has data issue: false hasContentIssue false
  • English
  • Français

Clozapine as a treatment tool: only in resistant schizophrenic patients?

Published online by Cambridge University Press:  16 April 2020

GB Cassano ,
A Ciapparelli  and
M Villa
GB Cassano
Affiliation:
Istituto di Psichiatria, Università di Pisa, Via Roma 67, 56100Pisa, Italy
A Ciapparelli
Affiliation:
Istituto di Psichiatria, Università di Pisa, Via Roma 67, 56100Pisa, Italy
M Villa
Affiliation:
Istituto di Psichiatria, Università di Pisa, Via Roma 67, 56100Pisa, Italy
Get access

Summary

Evidence indicates that clozapine is effective in the management of treatment-resistant schizophrenia and in affective psychoses. To examine whether affective components within the boundaries of the schizophrenia spectrum imply specific psychopathological characteristics of response to treatment, 60 patients with a treatment-resistant schizophrenia spectrum disorder who were treated with clozapine (75–600 mg/d) were evaluated in a naturalistic, open, follow-up study. The group comprised 41 patients with and 19 without bipolar features (43 men and 17 women, mean age 34.3 years). Patients were evaluated with the Brief Psychiatric Rating Scale (BPRS) during the first year of treatment. The results show a significant improvement in scores in both groups (P < 0.001) compared with the baseline evaluation. A higher percentage of responders was seen in the ‘affective’ group. No typical psychopathological characteristic or symptom cluster predicting the response to treatment was identified. During the study, 15 patients discontinued treatment: six for lack of efficacy, five for non-compliance and four for adverse events. The study confirms the efficacy of clozapine in the treatment of schizophrenia spectrum disorders, particularly in patients with bipolar features.

Keywords

clozapinetreatment-resistant schizophreniaaffective disordersBrief Psychiatric Rating Scale, Expanded Versionbipolar features
Type
Research Article
Information
European Psychiatry , Volume 12 , Issue S5 , 1997 , pp. 347s - 351s
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

American Psychiatric Association. Practice guideline for the treatment of patients with bipolar disorder. Am J Psychiatry 1994; 151: 1–36CrossRefGoogle Scholar
Andreasen, NCArndt, SAlliger, RMiller, DFlaum, M. Symptoms of schizophrenia. Methods, meanings, and mechanisms. Arch Gen Psychiatry 1995; 52: 341–351CrossRefGoogle ScholarPubMed
Angst, J. European long-term follow-up studies of schizophrenia. Schizophr Bull 1988; 14: 501–513CrossRefGoogle ScholarPubMed
Banov, MDZarate, CATohen, MScialabba, DWines, JDKolbrener, Met al.Clozapine therapy in refractory affective disorders: polarity predicts response in long-term follow-upJ Clin Psychiatry 55 1994 295–300Google Scholar
Calabrese, JRKimmel, SEWoyshville, MJRapport, DJFaust, CJThompson, PAMeltzer, HY. Clozapine for treatment-refractory mania. Am J Psychiatry 1996; 153: 759–764Google ScholarPubMed
Carpenter, WTKirkpatrick, B. The heterogeneity of the long-term course of schizophrenia. Schizophr Bull 1988; 14: 645–652CrossRefGoogle ScholarPubMed
Carpenter, WTBuchanan, RWThe heterogeneity of the long-term course of schizophreniaN Engl J Med 330 1994 681–690Google Scholar
Carson, RCThe schizophrenias. In: Adams, HESutker, PB eds. Comprehensive Handbook of Psychopathology. Washington, DC: Plenum Press, 1984; 411CrossRefGoogle Scholar
Crow, TJ. Nature of the genetic contribution to psychotic illness — a continuum viewpoint. Acta Psychiatr Scand 1990; 81: 401–408CrossRefGoogle ScholarPubMed
Crow, TJPsychotic continuum or disease entities? The critical impact of nosology on the problem of aetiology. In: Marneros, AAndreasen, NCTsuang, MT eds. Psychotic Continuum. New York: Springer-Verlag, 1995Google Scholar
Goodwin, FKJamison, KRManic-Depressive Illness. Berlin: Oxford University Press, 1990Google Scholar
Hegarty, JDBaldessarini, RTohen, MWaternaux, COepen, G. One hundred years of schizophrenia: a meta-analysis of the outcome literature. Am J Psychiatry 1994; 151: 1409–1416Google ScholarPubMed
Koreen, ARSiris, SGChakos, MAlvir, JMayerhoff, DLieberman, J. Depression in first-episode schizophrenia. Am J Psychiatry 1993; 150: 1643–1648Google ScholarPubMed
(editorial)Liddle, PCarpenter, WTCrow, TJ. Syndromes of schizophrenia. Classic literature. Br J Psychiatry 1994; 165: 721–727CrossRefGoogle ScholarPubMed
McElroy, SLDessain, ECPope, HGCole, JOKeck, PEFrankenberg, FRet al.. Clozapine in the treatment of psychotic mood disorders, schizoaffective disorder, and schizophrenia. J Clin Psychiatry 1991; 52: 411–414Google Scholar
Meltzer, HY. Emerging clinical uses of clozapine. Rev Contemp Pharmacother 1995; 6: 183–190Google Scholar
Strakowski, SMTohen, MStoll, ALFaedda, GLMayer, PVKolbrener, MLGoodwin, DC. Comorbidity in psychosis at first hospitalization. Am J Psychiatry 1993; 150: 752–757Google ScholarPubMed
Widiger, TAFrances, AJSweeney, M. Schizophrenia spectrum disorders. Curr Opin Psychiatry 1988; 1: 13–18CrossRefGoogle Scholar
Wyatt, RJ. Neuroleptics and the natural course of schizophrenia. Schizophr Bull 1991; 17: 325–351CrossRefGoogle ScholarPubMed
Zarate, CA Is clozapine monotherapy a mood stabiliser? 32nd Annual Meeting of the American College of Neuropsychopharmacology 1993Google Scholar
Submit a response

Comments

No Comments have been published for this article.