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Clinical Efficacy of Clozapine in Treatment-Refractory Schizophrenia: An Overview

Published online by Cambridge University Press:  06 August 2018

John M. Kane*
Affiliation:
Department of Psychiatry, Hillside Hospital, Division of Long Island Jewish Medical Center, Glen Oaks, New York, Albert Einstein College of Medicine, Bronx, New York

Abstract

The treatment of patients with schizophrenia who fail to respond to antipsychotic medications remains a challenge. Despite numerous attempts to establish effective somatic treatment approaches for this population, clozapine appears to be the only well established alternative. Depending upon trial duration and response criteria, between 30% and 60% of previously unresponsive patients appear to derive clinically significant benefit from clozapine. Clozapine also has important advantages in terms of its reduced propensity to produce extrapyramidal side-effects. Agranulocytosis remains an important risk, so strategies to improve the benefit-to-risk ratio should be explored. Issues such as trial duration, dosage, blood levels and predictors of response require additional study.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

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