Effectiveness of clozapine: A study from North India

There are few studies from India which have evaluated the usefulness and tolerability of clozapine from India.

To study the sociodemographic profile, clinical profile, comorbidity, side effects and outcome of subjects treated with clozapine.

For this study, the inpatient register was screened to obtain data of all patients admitted to the psychiatric inpatient unit during January 2000 to December 2006 and who were either started or continued on clozapine. Case records of 51 patients were taken up for the study.

Majority of the patients who were started on clozapine were male (80.4%), single (70.6%), unemployed (70.6%), educated up to or beyond 10 years of schooling (86.3%) and belonged to nuclear families (64.7%). More than three-fourth's of them had received two or more adequate antipsychotic trials before being considered for clozapine. The mean dose of clozapine was 298.97mg/day. During the inpatient stay (mean duration 63 days), there was significant reduction (34.7%) in PANSS rating after starting clozapine. Sialorrhoea was the most common side effect, reported by 58.8% of subjects. In terms of long term outcome at a mean duration of 3.99 (SD 3.13) years after starting clozapine, 37 cases were on clozapine at the time of last follow-up. While receiving clozapine, three cases developed leucopenia and four patients developed seizures.

Clozapine leads to reduction in psychopathology and sialorrhoea is the most common side effect reported.