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Use of clozapine in a mental handicap hospital — report of the first 17 patients

Published online by Cambridge University Press:  13 June 2014

Ahmed Boachie  and
Maria GA McGinnity
Ahmed Boachie
Affiliation:
Department of Child Psychiatry, The Royal Belfast Hospital for Sick Children (RBHSC), Falls Road, Belfast BT12, Northern Ireland
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Abstract

Objectives: To examine the process and outcome of use of clozapine in patients with mental handicap, with particular reference to selection of patients, response to treatment, adverse effects and withdrawal from treatment.

Methods: The case notes and medication charts of all patients commenced on clozapine between January 1991 and December 1994 were examined.

Results: Seventeen patients had been commenced on clozapine, the majority in the mild and moderate range of handicap. Fifteen had ICD-9 diagnosis of schizophrenia and all were refractory to conventional neuroleptics. Improvement was marked in 47% and substantial in 76%, with a mean daily dose of 453.8(sd = 238.5)mg and a range of 200mg-900mg. Reduction of aggressive behaviour was an important indicator of improvement. Five patients were withdrawn but only one related to side effects. Four patients had a past history of epilepsy and six others either developed seizures or EEG changes on treatment.

Conclusion: Clozapine use has been associated with considerable benefit in patients with mild and moderate handicap wh o have schizophrenia. In this population aggression responded well but a high prevalence of drug-induced epilepsy was evident.

Keywords

Mental handicapClozapineEpilepsyAggression
Type
Brief Reports
Information
Irish Journal of Psychological Medicine , Volume 14 , Issue 1 , March 1997 , pp. 16 - 19
Copyright
Copyright © Cambridge University Press 1997

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