A prospective study of clozapine in treatment-resistant schizophrenic patients

1989 ◽  
Vol 99 (S1) ◽  
pp. S68-S72 ◽  
Author(s):  
H. Y. Meltzer ◽  
B. Bastani ◽  
K. Young Kwon ◽  
L. F. Ramirez ◽  
S. Burnett ◽  
...  
1997 ◽  
Vol 12 (S5) ◽  
pp. 343s-346s ◽  
Author(s):  
E Alvarez ◽  
F Barón ◽  
J Perez-Blanco ◽  
D Puigdemont José Soriano ◽  
C Masip ◽  
...  

SummaryA 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.


1996 ◽  
Vol 13 (1) ◽  
pp. 13-18
Author(s):  
Isabelle Jalenques ◽  
Eliane Albuisson ◽  
Igor Tauveron

AbstractObjective: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.


1995 ◽  
Vol 25 (2) ◽  
pp. 365-371 ◽  
Author(s):  
Manuel Girón ◽  
Manuel Gomez-Beneyto

SynopsisA prospective study was carried out to investigate the relationship between family attitudes and relapse in a cohort of 80 schizophrenic patients followed up for 2 years. A significant relationship was found between attitudes as measured by means of a semantic differential during hospitalization and later relapse. Lack of treatment compliance, negative symptoms, unemployment and poor pre-morbid adjustment were also associated with relapse. In a multivariate analysis some of these variables changed their predictive power but the association between attitudes and relapse was maintained.


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