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Clozapine to treat aggression and agitation in advanced dementia

Published online by Cambridge University Press:  27 August 2024

A. E. Michael ,
N. Michael ,
A. Erfurth  and
M. Kujovic
A. E. Michael
Affiliation:
1Johannes Wesling Klinikum Minden, Minden
N. Michael
Affiliation:
2Krankenhaus Elbroich, Düsseldorf, Germany
A. Erfurth*
Affiliation:
31st Department of Psychiatry and Psychotherapeutic Medicine, Klinik Hietzing, Vienna, Austria
M. Kujovic
Affiliation:
4LVR-Klinikum , Düsseldorf, Germany
*
*Corresponding author.

Abstract

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Introduction

Agitation and aggression are a serious problem in clinical psychiatry, especially in multimorbid patients of advanced age, including those with dementia.

Objectives

We wanted to investigate to what extent clozapine could be an option in the treatment of selected refractory patients.

Methods

A retrospective study included patients with a diagnosis of dementia who were treated with clozapine in a specialist geriatric psychiatry unit between August 2018 and February 2022, and medical records were systematically reviewed. The Clinical Global Impressions Scale was used for the assessment of improvement and the Pittsburgh Agitation Scale for the assessment of symptom reduction. In addition, there was detailed documentation of side effects and clinical features.

Results

A total of 31 patients with a median age of 82 years were identified.

Conclusions

In conclusion, clozapine was effective and well tolerated in 23 patients. This suggests that low-dose clozapine may help alleviate the suffering of difficult-to-treat multimorbid patients with advanced dementia and their carers. However, adverse effects, particularly in patients with cardiovascular and pulmonary impairment, should be carefully monitored.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 67 , Special Issue S1: Abstracts of the 32nd European Congress of Psychiatry , April 2024 , pp. S231 - S232
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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