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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
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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

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