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Clozapine in treatment-resistant schizophrenic patients: preliminary results from an open prospective study

Published online by Cambridge University Press:  13 June 2014

Isabelle Jalenques
Affiliation:
Service de Psychiatrie A, Centre Médico Psychologique
Eliane Albuisson
Affiliation:
Service de Biostatisques
Igor Tauveron
Affiliation:
Service de Médecine, CHU Saint-Jacques BP 69, 63003 Clermont-Ferrand, Cedex, France

Abstract

Objective: This report describes an open prospective study of the effects of clozapine on positive and negative symptomatology in treatment resistant schizophrenic patients.

Method: In this prospective study, 15 DSM-III-R schizophrenic patients, who had failed to respond to various neuroleptics were followed up for a period of 21 months (median: 9; 25th and 75th percentiles: 4-10). When clozapine treatment was initiated, the mean duration of the illness was 16 +/-9 years. Brief Psychiatric Rating Scale (BPRS) scores, BPRS ‘positive symptoms’ and BPRS ‘anergia factor’ scores were all rated at days 0 and 15, months one, two and three and every three months thereafter.

Results: Significant improvements in total BPRS scores, BPRS positive symptoms and anergia factor were recorded and resulted in two distinct patterns of outcome. The improvements in BPRS scores translated into marked changes in health care utilisation and in sheltered employment. Of the side effects noted, dry mouth was more common in the first month after wash-out (three patients), while hypersalivation was more frequent after this period (eight patients). There was no agranulocytosis in this cohort. Two cases of eosinophilla occurred during the first month. Weight gain affected six patients.

Conclusions: We found that clozapine offers particular benefits for some treatment-resistant schizophrenic patients despite the increased hematologic risk. Our study also indicates that the beneficial effects of clozapine are delayed in relation to negative symptoms as compared with positive symptoms.

Type
Brief Reports
Copyright
Copyright © Cambridge University Press 1996

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