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An open trial of clozapine in neuroleptic-resistant childhood-onset schizophrenia

Published online by Cambridge University Press:  03 January 2018

M. Turetz ,
T. Mozes ,
P. Toren ,
T. Chernauzan ,
R. Yoran-Hegesh ,
R. Mester ,
N. Wittenberg ,
S. Tyano  and
A. Weizman
M. Turetz
Affiliation:
Child and Adolescent Outpatient Clinic, Ness Ziona Mental Health Center, Israel
T. Mozes
Affiliation:
Department of Inpatient Child Psychiatry, Ness Ziona Mental Health Center, and Sackler Faculty of Medicine, Tel Aviv University
P. Toren
Affiliation:
Ness Ziona Mental Health Center
T. Chernauzan
Affiliation:
Ness Ziona Mental Health Center
R. Yoran-Hegesh
Affiliation:
Ness Ziona Mental Health Center, and Sackler Faculty of Medicine, Tel Aviv University
R. Mester
Affiliation:
Ness Ziona Mental Health Center, and Sackler Faculty of Medicine, Tel Aviv University
N. Wittenberg
Affiliation:
Hebrew University, Jerusalem
S. Tyano
Affiliation:
Gehah Psychiatric Hospital, and Sackler Faculty of Medicine, Tel Aviv University
A. Weizman*
Affiliation:
Gehah Psychiatric Hospital, Felsenstein Medical Research Center, Beilinson Campus, Petah Tiqva, and Sackler Faculty of Medicine, Tel Aviv University, Israel
*
Dr A. Weizman, Gehah Psychiatric Hospital, PO Box 102. Peta Tiqva 49 100, Israel. Fax: 973-3-924-1041
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Abstract

Background

Studies performed with schizophrenic adults who were resistant to classical neuroleptics showed improvement in 30% of the patients when treated with clozapine. Very early onset schizophrenic patients benefit only partially from conventional antipsychotics and are at increased risk of developing extrapyramidal symptoms; clozapine may offer an alternative treatment for these patients.

Method

Eleven neuroleptic-resistant children (< 13 years) with schizophrenia were treated with clozapine. Improvement was monitored during the first 16 weeks using the Brief Psychiatric Rating Scale, Positive and Negative Syndrome Scale and Clinical Global Impression. The mean clozapine dosage was 227.3 (s.d. 34.4) mg/day at the end of the 16 weeks.

Results

There was an overall statistically significant reduction in all parameters, especially positive symptoms, implying a favourable outcome. Most of the improvement occurred during the first 6 to 8 weeks. The major side-effects were somnolence and drooling (no agranulocytosis).

Conclusion

Clozapine may be a promising drug for the treatment of resistant childhood-onset schizophrenia.

Type
Papers
Information
The British Journal of Psychiatry , Volume 170 , Issue 6 , June 1997 , pp. 507 - 510
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised) (DSM-III-R). Washington. DC: APA Google Scholar
Birmaher, B., Baker, R., Kapur, S., et al (1992) Clozapine for the treatment of adolescents with schizophrenia. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 160–164.CrossRefGoogle ScholarPubMed
Campbell, M. (1985) Schizophrenic disorders and pervasive developmental disorders/infantile autism. In Diagnosis and Psychopharmacology of Childhood and Adolescent Disorders (ed. Wiewer, J. M.). pp. 113–150. New York: John Wiley Google Scholar
Farde, L. & Nordstrom, A. L. (1992) PET analysis indicates atypical central dopamine receptor occupancy in clozapme-treated patients. British Journal of Psychiatry, 160 (suppl. 17), 30–33.CrossRefGoogle Scholar
Frailer, J. A., Gordon, C. T., Rapoport, J. L., et al (1994) An open trial of clozapine in 11 adolescents with childhood onset schizophrenia. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 658–663.Google Scholar
Gerlach, J., Koppelhus, P., Helweg, E., et al (1974) Clozapine and haloperidol in single-blind cross-over trial: therapeutic and biochemical aspects in the treatment of schizophrenia. Acta Psychiatrica Scandinavia, 50, 410–424.Google Scholar
Gilbert, P. L., Harris, M. J., McAdams, L. A., et al (1995) Neuroleptic withdrawal in schizophrenic patients: a review of the literature. Archives of General Psychiatry, 52, 173–188.CrossRefGoogle ScholarPubMed
Guy, W. (1976) ECDEV Assessment Manual for Psychopharmacology. Revised DHEW Pub (AOM). Rockville, MD: National Institute for Mental Health Google Scholar
Jann, M. W., Grimsley, S. R., Gray, E. C., et al (1993) Phar macokinetics and pharmacodynamics of clozapine. Clinical Pharmacokinetics, 24, 161–176.CrossRefGoogle Scholar
Kane, J. M., Honigfeld, G., Singer, J., et al (1988) Clozapine for the treatment-resistant schizophrenia: a double-blind comparison with chlorpromazine. Archives of General Psychiatry 45, 789–796.Google Scholar
Kay, S. R., Fishbein, A. & Opler, L. A. (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261–276.Google Scholar
King, R. A. & Noshpitz, J. D. (1991) Schizophrenia in childhood and adolescence with an overview of childhood psychosis. In Pathways of Growth - Essentials of Child Psychiatry. Vol. 2 (ed. Noshpitz, J. D.). pp. 96–97. New York: John Wiley Google Scholar
Lieberman, J. A., Johns, C. A., Kane, J. M., et al (1988) Clozapine-induced agranulocytosis: non-cross-reactivity with other psychotropic drugs. Journal of Clinical Psychiatry, 49, 271–277.Google Scholar
Lieberman, J. A., Johns, C. A., Kane, J. M., Kane, J. M. & Johns, C. A. (1989) Clozapine: guidelines for clinical management. Journal of Clinical Psychiatry, 50, 329–338.Google ScholarPubMed
McClellan, K. J. M. & Werry, J. S. (1992) Schizophrenia Psychiatric Clinics of North America, 15, 131–147.Google Scholar
Meitzer, H. Y. (1993) New drugs for the treatment of schizophrenia. Psychiatric Clinics of North America, 16, 365–385.CrossRefGoogle Scholar
Mozes, T., Toren, P., Chernauzen, T., et al (1994) Clozapine treatment in very early onset schizophrenia. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 65–70.Google Scholar
Naber, D., Holzbach, R., Perro, C., et al (1992) Clinical management of clozapine patients in relation to efficacy and side effects. British Journal of Psychiatry, 160 (suppl. 17), 54–59.CrossRefGoogle Scholar
Overall, J. E. & Gorham, D. R. (1962) The Brief Psychiatric Rating Scale (BPRS). Psychological Reports, 10, 799–812.CrossRefGoogle Scholar
Remschmidt, H. E., Schulz, E., Martin, M., et al (1994) Childhood onset schizophrenia: history of the concept and recent studies. Schizophrenia Bulletin, 20, 727–745.Google Scholar
Safferman, A., Lieberman, J. A., Kane, J. M., et al (1991) Update on the clinical efficacy and side effects of clozapine. Schizophrenia Bulletin, 17, 247–261.CrossRefGoogle ScholarPubMed
Tamminga, C. A., Thaker, G. K., Moran, M., et al (1994) Clozapine in tardive dyskinesia: observations from human and animal model studies. Journal of Clinical Psychiatry, 55 (suppl. B). 102–106.Google ScholarPubMed
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