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Clozapine in the back wards

T C Manschreck1, D A Redmond, S M Beaudette

  • 1Dartmouth Medical School, Concord, New Hampshire 03301, USA.

Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists
|December 1, 1994
PubMed
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Clozapine treatment demonstrated significant improvement in 94% of chronically hospitalized patients. This antipsychotic medication can reduce symptoms and healthcare costs, even in severe cases.

Area of Science:

  • Psychiatry
  • Pharmacology
  • Clinical Medicine

Background:

  • Clozapine is used for treatment-refractory schizophrenia, but data on chronically institutionalized patients are limited.
  • This population represents an extreme of treatment resistance with poor functioning.

Purpose of the Study:

  • To evaluate the clinical outcome of clozapine in persistently hospitalized, treatment-refractory patients.
  • To assess psychopathology, cognitive function, side effects, and patient satisfaction.

Main Methods:

  • Open-label trial analysis of 50 institutionalized patients receiving clozapine.
  • Outcomes assessed included psychopathology, cognition, extrapyramidal side effects (EPS), and patient satisfaction.

Main Results:

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  • 94% of patients showed some improvement with clozapine.
  • Improvements included reduced psychopathology, fewer extrapyramidal side effects (EPS), decreased use of restraint/seclusion, and reduced care costs.
  • Some patients experienced remarkable improvement, including discharge from the hospital.

Conclusions:

  • Clozapine is effective in a majority of chronically institutionalized, treatment-refractory patients.
  • Adequate trials of clozapine may require more than six months for optimal assessment.
  • Clozapine offers benefits beyond symptom reduction, including improved social interaction and cost-effectiveness.