Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T08:24:39.646Z Has data issue: false hasContentIssue false
  • English
  • Français

Dimensions of Outcome with Clozapine

Published online by Cambridge University Press:  06 August 2018

Herbert Y. Meltzer
Herbert Y. Meltzer*
Affiliation:
University Hospitals of Cleveland, Hanna Pavilion, Room B-68, 2040 Abington Road, Cleveland, OH 44106-5000, USA
Get access Rights & Permissions [Opens in a new window]

Abstract

Various outcome measures following clozapine administration to neuroleptic-resistant schizophrenic patients are considered. The importance of a multidimensional perspective is emphasised. There was significant improvement in positive symptoms, some negative symptoms, quality of life, some types of cognitive function (e.g. semantic memory), extrapyramidal function, and tardive dyskinesia. Readmission to hospital, and family burden were markedly reduced, which achieved significant savings in the cost of treatment. Compliance with clozapine and weekly blood testing can be achieved in the majority of treatment-resistant cases. These benefits may occur independently of each other.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 160 , Issue S17: Clozapine - The Atypical Antipsychotic , May 1992 , pp. 46 - 53
Copyright
Copyright © The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andreasen, N. C. (1982) Negative symptoms in schizophrenia: definition and reliability. Archives of General Psychiatry, 39, 784–788.CrossRefGoogle ScholarPubMed
Caine, E. D., Polinsky, R. J., Kartzinel, R., et al (1979) The trial use of clozapine for abnormal involuntary movement disorders. American Journal of Psychiatry, 136, 317–320.Google ScholarPubMed
Casey, D. E. (1989) Clozapine: neuroleptic-induced EPS and tardive dyskinesia. Psychopharmacology Bulletin, 99, S47–S53.CrossRefGoogle ScholarPubMed
Chapman, L. J. (1980) Recent advances in the study of schizophrenic cognition. In Special Report: Schizophrenia 1980, pp. 69–81. Washington, DC: Department of Health and Human Services.Google Scholar
Claghorn, J., Honigfeld, G., Abuzzahab, F. S., et al (1987) The risks and benefits of clozapine versus chlorpromazine. Journal of Clinical Psychopharmacology, 7, 377–384.CrossRefGoogle ScholarPubMed
Cohen, B. M., Keck, P. E., Satlin, A., et al (1991) Prevalence and severity of akathisia in patients on clozapine. Biological Psychiatry, 29, 1215–1219.CrossRefGoogle ScholarPubMed
Crow, T. J. (1980) Molecular pathology of schizophrenia: more than one disease process? British Medical Journal, 280, 66–68.CrossRefGoogle ScholarPubMed
Endicott, J. & Spitzer, R. L. (1978) A diagnostic interview: the schedule for affective disorders and schizophrenia. Archives of General Psychiatry, 35, 837–844.CrossRefGoogle ScholarPubMed
Gerlach, J., Thorsen, K. & Fog, R. (1975) Extrapyramidal reactions and amine metabolites in cerebrospinal fluid during haloperidol and clozapine treatment of schizophrenic patients. Psychopharmacologia, 40, 1341–1350.CrossRefGoogle ScholarPubMed
Gerlach, J. & Simmelsgaard, H. (1978) Tardive dyskinesia during and following treatment with haloperidol + biperiden, thioridazine and dopamine. Psychopharmacology, 59, 105–112.CrossRefGoogle Scholar
Guy, W. (1976) ECDEV Assessment Manual for Psychopharmacology, revised DHEW Pub. No. (ADM) 78-388. Rockville, MD: National Institute of Mental Health.Google Scholar
Hemsley, D. R. (1987) An experimental psychological model for schizophrenia. In Search for the Causes of Schizophrenia (eds Hafner, H., Gattaz, W. F. & Janzavik, W.). New York: Springer-Verlag.Google Scholar
Heinrichs, D. W., Hanlon, T. E. & Carpenter, W. T. Jr (1984) The Quality of Life Scale: an instrument for rating the schizophrenic deficit syndrome. Schizophrenia Bulletin, 10, 388–398.CrossRefGoogle ScholarPubMed
Honigfeld, G. & Klelt, G. (1965) The nurses’ observation scale for in-patient evaluation (NOSIE-30): A new scale for measuring improvement in chronic schizophrenia. Journal of Clinical Psychology, 21, 65–71.3.0.CO;2-I>CrossRefGoogle Scholar
Honigfeld, G. & Patin, J. (1990) Predictors of response to clozapine therapy. Psychopharmacology, 99, S64–S67.CrossRefGoogle Scholar
Kane, J., Honigfeld, G., Singer, J., et al (1988) Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. Archives of General Psychiatry, 45, 789–796.CrossRefGoogle ScholarPubMed
Kay, S. G., Opler, L. A. & Lindenmayer, J.-P. (1988) Reliability and validity of the Positive and Negative Syndrome Scale for schizophrenia. Psychiatry Research, 23, 99–110.CrossRefGoogle Scholar
Keepers, G. A., Clappison, V. J. & Casey, D. E. (1983) Initial anticholinergic prophylaxis for neuroleptic-induced extrapyramidal syndromes. Archives of General Psychiatry, 40, 1113–1117.CrossRefGoogle ScholarPubMed
Kenny, J. T. & Meltzer, H. Y. (1991) Attention and higher cortical functions in schizophrenia on semantic memory. Journal of Neuropsychiatry and Clinical Neurosciences, 3, 269–275.Google Scholar
Krupp, P. & Barnes, P. (1989) Leponex-associated granulocytopenia: a review of the situation. Psychopharmacology, 99, S118–S121.CrossRefGoogle ScholarPubMed
Lehman, A. F. (1983) The well-being of chronic mental patients: assessing their quality of life. Archives of General Psychiatry, 40, 369–373.CrossRefGoogle Scholar
Lieberman, J., Johns, C., Cooper, T., et al (1989) Clozapine pharmacology and tardive dyskinesia. Psychopharmacology, 99, S54–S59.CrossRefGoogle ScholarPubMed
Lindström, L. H. (1988) The effect of long-term treatment with clozapine in schizophrenia: a retrospective study in 96 patients treated with clozapine for up to 13 years. Acta Psychiatrica Scandinavica, 77, 524–529.CrossRefGoogle ScholarPubMed
Meltzer, H. Y. & Luchins, D. J. (1984) Effect of clozapine in severe tardive dyskinesia: a case report. Journal of Clinical Psychopharmacology, 4, 286–287.CrossRefGoogle ScholarPubMed
Meltzer, H. Y., Bastani, B., Kwon, K. Y., et al (1989) A prospective study of clozapine in treatment-resistant patients: I: Preliminary report. Psychopharmacology, 99, S68–S72.CrossRefGoogle ScholarPubMed
Meltzer, H. Y., Burnett, S., Bastani, B., et al (1990) Effect of six months of clozapine treatment on the quality of life of chronic schizophrenic patients. Hospital and Community Psychiatry, 41, 892–897.Google ScholarPubMed
Overall, J. E. & Gorham, D. R. (1962) Brief Psychiatric Rating Scale. Psychological Reports, 10, 799–812.CrossRefGoogle Scholar
Patterson, T. (1987) Studies toward the subcortical pathogenesis of schizophrenia. Schizophrenia Bulletin, 13, 555–576.CrossRefGoogle ScholarPubMed
Perlick, D., Stastny, P., Katz, U., et al (1986) Memory deficits and anticholinergic levels in chronic schizophrenia. American Journal of Psychiatry, 143, 230–232.Google ScholarPubMed
Povlsen, J. U., Noring, U., Fog, R., et al (1985) Tolerability of therapeutic effect of clozapine: a retrospective investigation of 216 patients treated with clozapine for up to 12 years. Acta Psychiatrica Scandinavica, 71, 176–195.CrossRefGoogle Scholar
Safferman, A., Lieberman, J. A., Kane, J. M., et al (1991) Update on clinical efficacy and side effects of clozapine. Schizophrenia Bulletin, 17, 247–262.CrossRefGoogle ScholarPubMed
Seidman, L. J. (1983) Schizophrenic and brain dysfunction: an integration of recent neurodiagnostic findings. Psychology Bulletin, 94, 195–238.CrossRefGoogle Scholar
Shopsin, B., Klein, H., Aaronson, M., et al (1979) Clozapine, chlorpromazine, and placebo in newly hospitalized acutely schizophrenic patients. Archives of General Psychiatry, 36, 657–664.CrossRefGoogle ScholarPubMed
Spohn, H. E. & Strauss, M. E. (1989) Relation of neuroleptic and anticholinergic medication to cognitive functions in schizophrenia. Journal of Abnormal Psychology, 98, 367–380.CrossRefGoogle ScholarPubMed
Strauss, J. S. & Carpenter, W. T. (1972) The prediction of outcome in schizophrenia: I. Characteristics of outcome. Archives of General Psychiatry, 21, 734–746.Google Scholar
Strauss, J. S., Carpenter, W. T. & Bartko, J. J. (1974) The diagnosis and understanding of schizophrenia: III. Speculations on the processes that underlie schizophrenic symptoms and signs. Schizophrenia Bulletin, 1, 61–69.CrossRefGoogle Scholar
Strauss, J. S. & Carpenter, W. T. (1978) The prognosis of schizophrenia: rationale for a multidimensional concept. Schizophrenia Bulletin, 4, 56–67.CrossRefGoogle ScholarPubMed
Van Putten, T. & Marder, S. R. (1974) Behavioral toxicity of antipsychotic drugs. Journal of Clinical Psychiatry, 48, 13–19.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.